Form 1321 Synagis Standard Prior Authorization Addendum (Medicaid) - Texas

What Is Form 1321?

This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 1321 Synagis Standard Prior Authorization Addendum?
A: Form 1321 Synagis Standard Prior Authorization Addendum is a document specific to Texas Medicaid that is used to request prior authorization for Synagis, a medication used to prevent respiratory syncytial virus (RSV) infection in high-risk infants.

Q: Who needs to complete Form 1321 Synagis Standard Prior Authorization Addendum?
A: Healthcare providers who want to prescribe Synagis to their patients and want to seek prior authorization from Texas Medicaid need to complete Form 1321 Synagis Standard Prior Authorization Addendum.

Q: What is Synagis?
A: Synagis is a medication used to prevent respiratory syncytial virus (RSV) infection in high-risk infants. It is given as a monthly injection during RSV season.

Q: What is the purpose of prior authorization?
A: Prior authorization is a process through which healthcare providers obtain approval from the insurance company or Medicaid program before prescribing certain medications or treatments. It ensures that the medication or treatment is medically necessary and covered by the insurance.

Q: When should Form 1321 Synagis Standard Prior Authorization Addendum be submitted?
A: Form 1321 Synagis Standard Prior Authorization Addendum should be submitted prior to prescribing Synagis to a patient, as it is required to obtain prior authorization for the medication.

Q: How can Form 1321 Synagis Standard Prior Authorization Addendum be submitted?
A: Form 1321 Synagis Standard Prior Authorization Addendum can be submitted electronically or by mail, as indicated by the Texas Medicaid program.

Q: Is there a fee for submitting Form 1321 Synagis Standard Prior Authorization Addendum?
A: No, there is no fee for submitting Form 1321 Synagis Standard Prior Authorization Addendum.

Q: How long does it take to receive a decision on prior authorization?
A: The processing time for prior authorization requests can vary. It is recommended to check with the Texas Medicaid program for their specific timeline.

Q: What happens if prior authorization is denied?
A: If prior authorization is denied, the healthcare provider will need to explore alternative treatment options or may need to submit an appeal for reconsideration.