This document contains official instructions for Form F-00281 , Prior Authorization/Preferred Drug List (Pa/Pdl) for Fentanyl Mucosal Agents - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-00281 is available for download through this link.
Q: What is Form F-00281?
A: Form F-00281 is a Prior Authorization/Preferred Drug List (PA/PDL) for Fentanyl Mucosal Agents in Wisconsin.
Q: What is the purpose of Form F-00281?
A: The purpose of Form F-00281 is to request prior authorization for fentanyl mucosal agents and to determine if they are included on the preferred drug list.
Q: Who needs to complete Form F-00281?
A: Healthcare providers who wish to prescribe fentanyl mucosal agents in Wisconsin need to complete Form F-00281.
Q: What information is required on Form F-00281?
A: Form F-00281 requires information about the patient, prescriber, drug being requested, medical necessity, and alternative treatments tried.
Q: Are there any fees associated with Form F-00281?
A: There are no fees associated with submitting Form F-00281.
Q: How long does it take to process Form F-00281?
A: Form F-00281 is typically processed within 10 business days.
Q: What happens after Form F-00281 is processed?
A: After Form F-00281 is processed, the healthcare provider will be notified if the prior authorization is approved or denied.
Q: Can I appeal a denied prior authorization?
A: Yes, if the prior authorization is denied, the healthcare provider can appeal the decision.
Q: Who can I contact for more information about Form F-00281?
A: For more information about Form F-00281, you can contact the Wisconsin Department of Health Services.
Instruction Details:
Download your copy of the instructions by clicking the link below or browse hundreds of other forms in our library of forms released by the Wisconsin Department of Health Services.