Form FA-199 Entresto (Sacubitril-Valsartan) Prior Authorization Request Form - Nevada

What Is Form FA-199?

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-199?
A: Form FA-199 is the Prior Authorization Request Form for Entresto (Sacubitril-Valsartan) in Nevada.

Q: What is Entresto?
A: Entresto is a medication that contains a combination of sacubitril and valsartan. It is used to treat heart failure.

Q: What is sacubitril?
A: Sacubitril is a neprilysin inhibitor that helps to increase the levels of certain substances that dilate blood vessels and reduce sodium and fluid retention.

Q: What is valsartan?
A: Valsartan is an angiotensin receptor blocker (ARB) that helps to relax blood vessels and lower blood pressure.

Q: Who needs to fill out Form FA-199?
A: Form FA-199 needs to be filled out by healthcare providers in Nevada who are requesting prior authorization for Entresto.

Q: What is the purpose of Form FA-199?
A: The purpose of Form FA-199 is to request prior authorization for the use of Entresto in Nevada.

Q: What information is needed on Form FA-199?
A: Form FA-199 requires information about the patient, healthcare provider, medical history, and justification for the use of Entresto.

Q: How long does it take to get a response for Form FA-199?
A: The response time for Form FA-199 can vary, but typically it takes a few days to a couple of weeks.