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Outsourcing Prior Authorization

Requirements for Renasense Non-Formulary Prior Authorization

Non-formulary medications like Renasense may be a better option for patients who don’t respond well to standard formulary medications. However, obtaining prior authorization (PA) for these medications can be complex. Insurance providers require thorough documentation to prove that all formulary options have been tried and found ineffective or intolerable. In this case, the patient experienced adverse effects or insufficient relief with standard treatments, making Renasense a better fit. This guide will guide you through the steps to obtain PA for

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Doctor checking blood pressure of a patient in a hospital bed, symbolizing care for asthma treatment with non-formulary medication.

Outsourcing Prior Authorization

How to Get Prior Authorization for Betasolol with New Jersey Medicaid?

Imagine you’re working with a patient who has been struggling with asthma symptoms that just won’t seem to go away, even after trying several different medications. They’ve found relief with Betasolol Suspension 0.5mg, a non-formulary bronchodilator that effectively manages their asthma by relaxing their airway muscles and easing their breathing. However, since Betasolol isn’t part of New Jersey Medicaid’s preferred medication list, the insurance provider requires prior authorization (PA) to cover it. In this guide, we’ll go through each step

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