YourFully Integrated Pharmacy Benefit Manager
Here is what you should know if your prescription rejects for Prior Authorization:
PHARMA C Y
S TO P
APPROVED Get Healthy and Stay Healthy!
DENIED (for Prior Authorization requirement)
DO NOT LEAVE THE PHARMACY
HAVE YOU BEEN ON THE MEDICATION BEFORE? ?
YES
NO
If ProAct can verify that you’ve been on the medication previously, and it is covered through your plan . . .
CALL THE PROACT HELP DESK 1 – 877 – 635 – 9545
1
CONTACTYOUR DOCTOR (Notify them your prescription has been denied due to a Prior Authorization requirement.)
PROACTWILL GRANT A ONE-TIME OVERRIDE (up to a 30 day supply)
YOU WILL STILL NEED TO CONTACTYOUR DOCTOR to initiate the Prior Authorization process
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