Step therapy exception definition

Step therapy exception means a process by which a step therapy

Step therapy exception means a decision to override a generally applicable step therapy protocol in favor of coverage of the prescription drug prescribed by a health care provider for an individual enrollee.

Step therapy exception means that a step therapy protocol should be overridden in

Examples of Step therapy exception in a sentence

• Step therapy exception requestYour health care practitioner may submit to us a written step therapy exception request for a clinically appropriate prescription drug.

• Step therapy exception is the exception to the step therapy process and the determination of whether the exception shall be granted, taking into consideration the enrollee’s needs and medical circumstances, along with the professional judgment of the enrollee’s provider.

• Oncology Step Therapy Exception Requests Step therapy exception requests for members with stage 3 or 4 cancer for oncology related medications can be submitted on the Online Provider Center, or faxed to (800) 282-8845.

• Step therapy exception requestSAMPLEAn exception for any clinically appropriate prescription drug can be requested by you or your appointed representative when step therapy: Has been ineffective in the treatment of your disease or medical condition;Is likely to be ineffective or adversely affect the drug's effectiveness or patient compliance; or Has caused or, based on sound medical evidence, is likely to cause an adverse reaction or harm to you.

• Step therapy exception requestAn exception for any clinically appropriate prescription drug can be requested by you or your appointed representative when step therapy:Has been ineffective in the treatment of your disease or medical condition.Is likely to be ineffective or adversely affect the drug's effectiveness or patient compliance; or Has caused or, based on sound medical evidence, is likely to cause an adverse reaction or harm to you.

More Definitions of Step therapy exception

Step therapy exception means a process that provides that a step therapy protocol

Step therapy exception means the overriding of a step therapy

Step therapy exception means overriding a step therapy protocol in favor of immediate coverage of

Step therapy exception means that a step therapy protocol is overridden in favor of immediate coverage of the healthcare provider's selected prescription drug;

Step therapy exception means a process by which a step therapy protocol is overridden in favor of immediate coverage of the healthcare provider's selected prescription drug;

Step therapy exception means a decision to override a

Step therapy exception means a determination that a step therapy protocol should be overridden in favor of immediate coverage of the health care provider's selected prescription drug; and