PDF
Word
Form 412 Short Acting Opiate Naive Days' Supply Limit Override - Alabama
What Is Form 412?
This is a legal form that was released by the Alabama Medicaid Agency - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 412?
A: Form 412 is a document used for requesting a days' supply limit override for short-acting opiates in Alabama.
Q: What does 'short-acting opiate naive' mean?
A: 'Short-acting opiate naive' refers to individuals who have not previously been prescribed or used short-acting opiates.
Q: What is a days' supply limit override?
A: A days' supply limit override is a request to exceed the usual limit on the number of days' worth of medication that can be prescribed.
Q: Why would someone need a days' supply limit override for short-acting opiates?
A: A days' supply limit override may be needed in certain cases where the patient requires a longer duration of medication than the standard limit allows.
Q: Who can use Form 412 in Alabama?
A: Form 412 can be used by healthcare providers in Alabama who need to request a days' supply limit override for short-acting opiates.
Q: Are there any specific requirements for using Form 412?
A: Yes, there are specific requirements that need to be met for using Form 412, such as accurate and complete documentation of the patient's medical condition and justification for the override request.
Q: How long does it take to process a Form 412 request?
A: The processing time for a Form 412 request may vary, but it is typically done within a reasonable time frame.
Q: Can a days' supply limit override be granted for any medication?
A: No, a days' supply limit override is specific to short-acting opiates and cannot be granted for other types of medications.
Q: Is there a limit on the number of days' supply that can be requested through a Form 412 override?
A: Yes, there is a maximum limit on the number of days' supply that can be requested through a Form 412 override, which may vary depending on the circumstances.
Form Details:
- Released on August 3, 2022;
- The latest edition provided by the Alabama Medicaid Agency;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form 412 by clicking the link below or browse more documents and templates provided by the Alabama Medicaid Agency.
