Instructions for Form F-02433 Prior Authorization / Preferred Drug List (Pa / Pdl) for Epidiolex - Wisconsin

Form F-02433 Prior Authorization/Preferred Drug List (Pa/Pdl) for Epidiolex - Wisconsin

This document contains official instructions for Form F-02433 , Prior Authorization/Preferred Drug List (Pa/Pdl) for Epidiolex - a form released and collected by the Wisconsin Department of Health Services. An up-to-date fillable Form F-02433 is available for download through this link.

FAQ

Q: What is Form F-02433?A: Form F-02433 is a prior authorization/preferred drug list form for Epidiolex in Wisconsin.

Q: What is the purpose of Form F-02433?A: The purpose of Form F-02433 is to request prior authorization for the use of Epidiolex or to include it on the preferred drug list in Wisconsin.

Q: What is prior authorization?A: Prior authorization is a process in which healthcare providers must get approval from the insurance company before prescribing a specific medication.

Q: What is a preferred drug list?A: A preferred drug list is a list of medications that are preferred by an insurance company or pharmacy benefit manager, usually because they are cost-effective or have demonstrated clinical benefits.

Q: What is Epidiolex?A: Epidiolex is a prescription medication that contains cannabidiol (CBD) and is approved by the FDA for the treatment of seizures associated with Lennox-Gastaut syndrome or Dravet syndrome.

Q: Who needs to use Form F-02433?A: Healthcare providers who want to prescribe Epidiolex in Wisconsin need to use Form F-02433 to request prior authorization or include it on the preferred drug list.

Q: What information is required on Form F-02433?A: Form F-02433 requires information such as patient details, medical diagnosis, healthcare provider information, medication details, and any supporting clinical documentation.

Q: How long does it take to get a response to a prior authorization request?A: The response time for a prior authorization request may vary, but it typically takes a few business days to receive a decision from the insurance company or pharmacy benefit manager.