Prescribed Drugs Provider Manual - Iowa Department of Human ...

IowaDepartmentof HumanServicesProvider and ChapterPrescribed DrugsChapter III. Provider-Specific PoliciesPage23DateAugust 1, 20132. Submitting a Prior Authorization RequestCompleted drug prior authorization requests must be submitted via FAX tothe IME Drug Prior Authorization Unit at 800-574-2515.Regular working hours for the provider help desk are Monday through Friday,8:00 a.m. to 5:00 p.m.After-hours calls for emergency requests and emergency requests on staterecognizedholidays are routed to the pharmacy pager voicemail system,where an on-call pharmacist is available for assistance.State-recognized holidays are as follows:♦ New Year’s Day♦ Martin Luther King Jr.’s birthday♦ Memorial Day♦ Independence Day♦ Labor Day♦ Veterans’ Day♦ Thanksgiving Day♦ The Friday following Thanksgiving♦ Christmas DayUnder the Health Insurance Portability and Accountability Act, there is anelectronic transaction for prior authorization requests (278 transaction).However, there is no standard to use in submitting additional documentationelectronically.Therefore, if you submit a prior authorization request electronically, you mustsubmit the additional documentation on paper using the following procedure:♦ Complete form 470-3970, Prior Authorization Attachment Control. Toview a sample of this form on line, click here.Complete the “attachment control number” with the same numbersubmitted on the electronic prior authorization request. IME will acceptup to 20 characters (letters or digits) in this number. If you do not knowthe attachment control number for the request, please contact the personin your facility responsible for electronic claims billing.♦ Staple the additional information to the Prior Authorization AttachmentControl.