This page contains forms and resources for prescribers and their office staff. Download prior authorization forms, submit a MAC appeal, and find answers to common questions.
Access Prior Authorization Request Forms.
If you have questions, please call
For how the review process works, see Prior Auth & Clinical Support →
Additional resources will be posted here as they become available.
A formulary is a list of medications chosen by a committee comprised of physicians and pharmacists. The committee periodically reviews prescription medications and, using strict criteria such as safety and efficacy, determines whether the drug should be considered for the formulary list.
The best way to take advantage of the Formulary program is by consulting with your physician. You can provide your physician with a printed copy of the Formulary that he or she may consult when prescribing medications to ensure that you get the most benefit from your formulary plan.
If your physician prescribes a non-Formulary drug, your pharmacist may be aware of Formulary dispensing opportunities at the time your prescription is being filled. Your pharmacist has the option to consult with your physician about changing the prescription to the preferred medication. If the physician cannot be reached or does not approve the Formulary alternative, the pharmacist dispenses the prescription as originally written.
Yes. The P&T committee meets quarterly. External physicians plus external and internal pharmacists make up the committee. It sets both the formulary and the PA criteria: which medications are added to or excluded from the formulary, which require prior authorization and on what criteria, and which carry restrictions and what those restrictions are.
Prescribers can use either an e-prescribing tool or an online formulary.
Prescribers can call 480-561-6005 for assistance.
