Form F-01672 Prior Authorization / Preferred Drug List (Pa / Pdl) for Non-preferred Stimulants - Wisconsin

Fill PDF Online

Fill out online for free

without registration or credit card

Instructions for Form F-01672 Prior Authorization/Preferred Drug List (Pa/Pdl) for Non-preferred Stimulants - Wisconsin

What Is Form F-01672?

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-01672?
A: Form F-01672 is the Prior Authorization/Preferred Drug List (Pa/Pdl) specifically for non-preferred stimulants in Wisconsin.

Q: What is the purpose of Form F-01672?
A: The purpose of Form F-01672 is to request prior authorization for non-preferred stimulant medications through the Preferred Drug List (PDL) in Wisconsin.

Q: Who needs to use Form F-01672?
A: Individuals who are prescribed non-preferred stimulant medications in Wisconsin may need to use Form F-01672 to request prior authorization for their medication.

Q: What are non-preferred stimulant medications?
A: Non-preferred stimulant medications are stimulant drugs that are not on the preferred drug list in Wisconsin.

Q: What is prior authorization?
A: Prior authorization is a process where the prescribing healthcare provider requests approval from the insurance company before a non-preferred medication can be covered.

Q: What is the preferred drug list (PDL)?
A: The preferred drug list (PDL) is a list of medications that are preferred and covered by the insurance company without prior authorization.

Q: What information is required on Form F-01672?
A: Form F-01672 typically requires information such as the patient's demographics, prescribing provider's information, medication details, and reasons for requesting non-preferred medication.

Q: How long does the prior authorization process take?
A: The length of the prior authorization process can vary, but it usually takes a few business days to receive a decision from the insurance company.

Q: What happens if prior authorization is denied?
A: If prior authorization is denied, the individual and their healthcare provider can explore other options such as appealing the decision or considering alternative medications on the preferred drug list.