prior authorization revisited.

Dr. Wayne Simon · medicine forum Guru Wannabe Joined: 30 Apr 2005 Posts: 111

It looks like several states will have medicaid formularies that will have
to be followed. If the physician wants nexium and previcid and protonix are
on the state formulary, prior authorization is needed by the physician from
medicaid before the pharmacy can get reimbursed, and theoretically the
ability to do so, should be electronically transmitted to the pharmacist and
medicaid billilng, or else the patient will have to pay the full cost of the
drug as reimbursement will not occur.

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