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Form ODM10245 Prior Authorization Sublocade - Ohio
What Is Form ODM10245?
This is a legal form that was released by the Ohio Department of Medicaid - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form ODM10245?
A: Form ODM10245 is a prior authorization form specifically for Sublocade in Ohio.
Q: What is Prior Authorization?
A: Prior Authorization is a process where healthcare providers need approval from the insurance company to prescribe certain medications or treatments.
Q: What is Sublocade?
A: Sublocade is a medication used for the treatment of opioid use disorder. It is a once-monthly injection that contains buprenorphine.
Q: How do I use Form ODM10245?
A: To use Form ODM10245, the healthcare provider needs to fill out the form with the necessary information and submit it to the insurance company for prior authorization.
Q: Who can use Form ODM10245?
A: Form ODM10245 is specifically for healthcare providers in Ohio who are seeking prior authorization for prescribing Sublocade.
Form Details:
- Released on July 1, 2019;
- The latest edition provided by the Ohio Department of Medicaid;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form ODM10245 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.
Download Form ODM10245 Prior Authorization Sublocade - Ohio
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