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Get Oh Medco-31 2016-2025
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How to fill out the OH MEDCO-31 online
The OH MEDCO-31 form is essential for requesting prior authorization of medication for injured workers. This guide provides step-by-step instructions on how to complete the form accurately and efficiently.
Follow the steps to complete your OH MEDCO-31 form online.
- Press the ‘Get Form’ button to access the OH MEDCO-31 form, which will open in your chosen editor.
- Begin by entering the injured worker information. Fill out the request date, BWC claim number, injured worker name, and the date of injury.
- Next, complete the prescriber information by providing the prescriber’s name, NPI, phone number, and fax number.
- In the medication requested section, enter the medication name and appropriate ICD code(s) along with their descriptions.
- Indicate whether the request is for a non-sterile compound or a sterile compound pain pump. Ensure to answer if it is a brand name drug and provide the necessary documentation related to medication allergies.
- If the request is for post-surgical medication, include the date of scheduled surgery.
- Document the justification for the request, ensuring to explain how the medication relates to the treatment of the conditions in the claim. Attach a separate sheet if necessary.
- Finally, ensure the prescriber signature is included along with the date of signature. Review all sections for accuracy.
- Once completed, save your changes, then download, print, or share the form as needed, and fax the completed form to 866-213-6066.
Complete your OH MEDCO-31 form online today for efficient processing.
Filing for workers' compensation in Ohio involves notifying your employer about your injury along with submitting necessary documentation, including the OH MEDCO-31. Make sure to keep detailed records of your treatment and claims submissions. To assist with this process, consider using US Legal Forms, which provides the official documents you need for filing. They offer a user-friendly platform to ensure that you meet all legal requirements efficiently.
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