Form ODM10243 Prior Authorization Oral Medication Assisted Treatment of Opioid Use Disorder - Ohio

Form ODM10243 Prior Authorization Oral Medication Assisted Treatment of Opioid Use Disorder - Ohio

What Is Form ODM10243?

This is a legal form that was released by the Ohio Department of Medicaid - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is the ODM10243 form?A: ODM10243 is the Prior Authorization form for oral medication assisted treatment of opioid use disorder in Ohio.

Q: What is the purpose of the form?A: The form is used to request prior authorization for medication assisted treatment of opioid use disorder with oral medications.

Q: Who can use the form?A: The form is intended for healthcare providers in Ohio who are seeking to initiate or continue oral medication assisted treatment for opioid use disorder.

Q: What types of medications are covered by the form?A: The form is specifically for oral medications used in medication assisted treatment of opioid use disorder, such as buprenorphine or naltrexone.

Q: What information is required on the form?A: The form requires various information including patient demographics, diagnosis, treatment history, and details of the requested medication treatment plan.

Q: How long does the prior authorization process take?A: The processing time for prior authorization requests can vary, but generally, a response is provided within 14 business days.

Q: Can the form be submitted electronically?A: Yes, the ODM10243 form can be submitted electronically through the Ohio Department of Medicaid's secure web portal.

Q: Is prior authorization required for all medication assisted treatment for opioid use disorder?A: No, prior authorization is only required for oral medication assisted treatment. Other forms of medication assisted treatment, such as injectable medications, may have their own authorization processes.

Q: What if the prior authorization request is denied?A: If a prior authorization request is denied, the healthcare provider can appeal the decision or explore alternative treatment options for the patient.

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Form Details:

  • Released on December 1, 2019;
  • The latest edition provided by the Ohio Department of Medicaid;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form ODM10243 by clicking the link below or browse more documents and templates provided by the Ohio Department of Medicaid.

Download Form ODM10243 Prior Authorization Oral Medication Assisted Treatment of Opioid Use Disorder - Ohio

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