DOC Form 140130D Non-formulary Medication Request Form - Oklahoma

What Is DOC Form 140130D?

This is a legal form that was released by the Oklahoma Department of Corrections - a government authority operating within Oklahoma. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 140130D?
A: Form 140130D is a Non-formulary Medication Request Form.

Q: What is a non-formulary medication?
A: A non-formulary medication is a drug that is not on the approved list of medications covered by an insurance plan.

Q: When would I need to use Form 140130D?
A: You would need to use Form 140130D when you want to request coverage for a non-formulary medication.

Q: Is Form 140130D specific to Oklahoma?
A: Yes, Form 140130D is specific to Oklahoma.

Q: What information is required on Form 140130D?
A: Form 140130D requires information such as the patient's name, insurance information, prescribing healthcare provider, and details about the medication being requested.

Q: What happens after I submit Form 140130D?
A: After you submit Form 140130D, your insurance company will review the request and decide whether or not to cover the non-formulary medication.

Q: Can I appeal a denial of coverage for a non-formulary medication?
A: Yes, you can appeal a denial of coverage for a non-formulary medication by following the appeals process outlined by your insurance company.

Q: Can I use Form 140130D for medications not covered by any insurance plan?
A: No, Form 140130D is specifically for requesting coverage for non-formulary medications under an insurance plan.

Q: Are there any fees associated with submitting Form 140130D?
A: There may be fees associated with submitting Form 140130D, such as copayments or deductibles, depending on your insurance plan.