Will the pharmacist receive any information regarding formulary requirements from a plan such as step therapy, quantity limits, or prior authorization requirements, when they submit a claim?
Yes. Pharmacists are encouraged to pay attention to any special messaging they may receive through the claims processing system. Some of these messages may include information regarding the need for prior authorization or the need to take action (calling a plan’s hotline to ensure the processing of a transition supply of drug).
Related Questions
- Will the pharmacist receive any information regarding formulary requirements from a plan such as step therapy, quantity limits, or prior authorization requirements, when they submit a claim?
- If my medication is considered preventive on the formulary, do step therapy and/or prior authorization requirements still apply?
- What drugs have STEP Therapy requirements?
