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

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

This document contains official instructions for Form F-01672 , Prior Authorization/Preferred Drug List (Pa/Pdl) for Non-preferred Stimulants - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-01672 is available for download through this link.

FAQ

Q: What is Form F-01672?
A: Form F-01672 is a Prior Authorization/Preferred Drug List (Pa/Pdl) 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 in Wisconsin.

Q: What is a Prior Authorization?
A: Prior Authorization is a process where healthcare providers must get approval from an insurance company before they can prescribe certain medications.

Q: What are Non-preferred Stimulants?
A: Non-preferred stimulants are medications that are not included in the preferred drug list for stimulant medications in Wisconsin.

Q: How can healthcare providers request Prior Authorization using Form F-01672?
A: Healthcare providers can request Prior Authorization by completing and submitting Form F-01672.

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

Q: Why do some stimulant medications require Prior Authorization?
A: Some stimulant medications require Prior Authorization to ensure that they are used appropriately and in accordance with insurance coverage policies.

Q: What information is required to complete Form F-01672?
A: To complete Form F-01672, healthcare providers will need to provide patient information, medication details, diagnosis information, and any supporting documentation.

Q: Who can healthcare providers contact for assistance with Form F-01672?
A: Healthcare providers can contact the insurance company or the Wisconsin Department of Health Services for assistance with Form F-01672.