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CVS Caremark Prior Authorization (PA) tools are developed to ensure safe, effective and appropriate use of selected drugs. Prior Authorization can ensure proper patient selection, dosage, drug administration and duration of selected drugs.
CVS Caremark has made submitting PAs easier and more convenient. Some automated decisions may be communicated in less than 6 seconds! We've partnered with CoverMyMeds ® and Surescripts ® , making it easy for you to access electronic prior authorization (ePA) via the ePA vendor of your choice.
Prior Authorization Forms. PA Forms for Physicians. When a PA is needed for a prescription, the member will be asked to have the physician or authorized agent of the physician contact our Prior Authorization Department to answer criteria questions to determine coverage.
The CVS Caremark Guide: Best Practices in Prior Authorization. Download the guide. Case study. What is smart logic PA? Our smart logic PA helps prevent off-label coverage of GLP-1s approved to treat type 2 diabetes. See how it helped one client reduce spend by 11% in just two months. View transcript.
Our employees are trained regarding the appropriate way to handle members’ private health information. This document contains references to brand-name prescription drugs that are trademarks or registered trademarks of pharmaceutical manufacturers not affiliated with CVS Caremark. 1.
See if your Rx requires prior authorization and learn more about the process when you sign in or register.
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To get started, sign in or register for an account at Caremark.com, or with our mobile app. Use our drug cost and coverage tool to enter the drug name, choose your prescribed amount, and search. Results will show prices for brand name, generics, or therapeutic alternatives covered under your plan.
THE CVS CAREMARK GUIDE: Best Practices in Prior Authorization. Prior authorization (PA) is one of the most important drug utilization management (UM) tools. PA is critical to helping manage coverage, control trend, and keep pharmacy benefits afordable.
CLINICAL PRIOR AUTHORIZATION CRITERIA REQUEST FORM. Please complete this form and fax it to CVS Caremark at 1-888-836-0730 to receive a DRUG SPECIFIC CRITERIA FORM for prior authorization.