Instructions for Form F-00081 Prior Authorization / Preferred Drug List (Pa / Pdl) for Opioid Dependency Agents - Buprenorphine - Wisconsin

Form F-00081 Prior Authorization/Preferred Drug List (Pa/Pdl) for Opioid Dependency Agents - Buprenorphine - Wisconsin

This document contains official instructions for Form F-00081 , Prior Authorization/Preferred Drug List (Pa/Pdl) for Opioid Dependency Agents - Buprenorphine - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-00081 is available for download through this link.

FAQ

Q: What is Form F-00081?
A: Form F-00081 is the Prior Authorization/Preferred Drug List (Pa/Pdl) for Opioid Dependency Agents - Buprenorphine in Wisconsin.

Q: What is the purpose of Form F-00081?
A: The purpose of Form F-00081 is to request prior authorization for the use of buprenorphine, a medication used to treat opioid dependency.

Q: Who needs to use Form F-00081?
A: Healthcare providers who are prescribing or administering buprenorphine for the treatment of opioid dependency need to use Form F-00081.

Q: What information is required on Form F-00081?
A: Form F-00081 requires information such as patient details, prescriber information, diagnosis, and treatment plan.

Q: Is prior authorization required for buprenorphine in Wisconsin?
A: Yes, prior authorization is required for buprenorphine in Wisconsin.

Q: How can healthcare providers obtain Form F-00081?
A: Healthcare providers can obtain Form F-00081 from the Wisconsin Department of Health Services or their managed care organization.

Q: Is buprenorphine covered by insurance in Wisconsin?
A: Coverage for buprenorphine may vary depending on the insurance plan. Prior authorization is often required.

Q: Are there any specific criteria for buprenorphine prior authorization?
A: Yes, there are specific criteria that need to be met for buprenorphine prior authorization, including documented diagnosis of opioid dependency and treatment plan.