Get Ppi Pa Form - Magellan Health Services Tenncare Portal

TennCare has up to 45 days to process your application after you have turned in all the information they request. TennCare will make a determination. You will receive a notice in the mail stating whether your application was approved or denied.

Fax PA Requests For drug specific forms please see the Forms tab under Resources. Please alert the member that the above steps will take additional time to complete. If this is an urgent prescription, have the member call Magellan Customer Service at 800-424-3312.

Magellan Rx's employer business clients cover Ozempic as a preferred brand for diabetes, and Wegovy is a nonpreferred brand for weight loss with prior authorization being required for both drugs. But not all clients opt to cover weight loss management and Wegovy, the spokesperson said.

A Tennessee Medicaid Prior Authorization Form is a document used by medical offices in the State of Tennessee to request Medicaid coverage for a non-preferred drug. The person filling the form must provide medical justification as to why they are not prescribing a drug from the PDL (Preferred Drug List).

To request prior authorization, please submit your request online or by phone. Prior authorization is not required for emergency or urgent care. Out-of-network physicians, facilities and other health care providers must request prior authorization for all procedures and services, excluding emergent or urgent care.

Fax this form to: 1-800-424-3260 A fax cover sheet is not required.

On the Coverage Overview page, click My Documents from the Left Navigation Menu to access the Documents We Need page. This page allows you to upload documents for an individual. You can also upload documents immediately after you submit an application, change, or renewal through TennCare Access.

You may also request the form by mailing a letter to Division of TennCare, RFR Processing Unit, 310 Great Circle Road, 3rd Floor, Nashville, TN 37243 or a faxing a letter to (615) 413-1941. Follow all of the instructions on the Request for Release Form and transmit it to TennCare as directed on the form.