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Form F-01430 Prior Authorization Drug Attachment for Xyrem and Xywav - Wisconsin
What Is Form F-01430?
This is a legal form that was released by the Wisconsin Department of Health Services - a government authority operating within Wisconsin. Check the official instructions before completing and submitting the form.
FAQ
Q: What is Form F-01430?
A: Form F-01430 is a Prior Authorization Drug Attachment specifically for Xyrem and Xywav in Wisconsin.
Q: What is Xyrem?
A: Xyrem is a medication used to treat narcolepsy, a sleep disorder, and cataplexy, a sudden loss of muscle strength.
Q: What is Xywav?
A: Xywav is another medication used to treat narcolepsy, a sleep disorder, and cataplexy, a sudden loss of muscle strength.
Q: What is a Prior Authorization?
A: Prior Authorization is a process where the healthcare provider must get approval from the insurance company before prescribing certain medications.
Q: Why do I need to fill out the Form F-01430?
A: The Form F-01430 is required by the insurance company in Wisconsin for Xyrem and Xywav to determine if the medication is medically necessary.
Form Details:
- Released on December 1, 2021;
- The latest edition provided by the Wisconsin Department of Health Services;
- 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 F-01430 by clicking the link below or browse more documents and templates provided by the Wisconsin Department of Health Services.
Download Form F-01430 Prior Authorization Drug Attachment for Xyrem and Xywav - Wisconsin
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