New Uniform Prescription Drug Prior Authorization Form
As of January 1, 2019, the State of Louisiana requires all health care providers to use their state-specific form for prescription drug prior authorization requests.
Health care providers should entirely fill out and submit the completed form to the fax number listed on the form. Please include any additional documentation such as clinical notes, lab values, etc. that support your prior authorization request.
NOTE:Any prior authorization requests that are not submitted using the Louisiana Uniform Prescription Drug Prior Authorization Form will be cancelled and the health care provider will be asked to re-submit their request using the correct form.
Streamline Your Prior Authorization Process with CoverMyMeds
CoverMyMeds streamlines the medication prior authorization process, electronically connecting providers, pharmacists and plan/PBMs to improve time to therapy and decrease prescription abandonment with electronic prior authorization.
Get Real-Time Prescription Costs and Coverage Detail
The PreCheck MyScript Solution on Link helps make it easy to run a pharmacy trial claim and get real-time prescription coverage detail for your patients who are UnitedHealthcare benefit plan members.