Form FA-195 Xywav (Oxybate Salts) Prior Authorization Request Form - Nevada

What Is Form FA-195?

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

FAQ

Q: What is Form FA-195 Xywav?
A: Form FA-195 Xywav is a prior authorization request form for the medication Xywav (Oxybate Salts).

Q: What is Xywav?
A: Xywav is a medication that contains Oxybate Salts and is used to treat narcolepsy.

Q: What is a prior authorization request form?
A: A prior authorization request form is a document that needs to be filled out and submitted to obtain approval from the insurance company for coverage of a specific medication or treatment.

Q: Who can use Form FA-195 Xywav?
A: Form FA-195 Xywav is specific to residents of Nevada who are seeking prior authorization for Xywav.

Q: What information is required on Form FA-195 Xywav?
A: Form FA-195 Xywav requires information such as patient details, healthcare provider information, diagnosis, medication details, and supporting documentation.

Q: How long does it take to get a response to a prior authorization request?
A: The time taken to obtain a response to a prior authorization request can vary, but it is typically within a few business days.

Q: What should I do if my prior authorization request is denied?
A: If your prior authorization request is denied, you can talk to your healthcare provider or insurance company to discuss alternative options or to appeal the decision.

Q: Is Xywav covered by insurance?
A: Insurance coverage for Xywav may vary depending on the specific insurance plan. Prior authorization is often required to determine coverage.