181![Understanding Prior Authorization As you navigate your health care, it’s important to note there are certain medical services or provider visits that will require prior authorization by Dean Health Plan. The process be Understanding Prior Authorization As you navigate your health care, it’s important to note there are certain medical services or provider visits that will require prior authorization by Dean Health Plan. The process be](https://www.pdfsearch.io/img/3ed6d5e76e8b504c2fac30927edb3cc0.jpg) | Add to Reading ListSource URL: www.deancare.comLanguage: English - Date: 2013-05-29 12:04:00
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182![Passport Health Plan Medication Prior Authorization White Blood Cell Stimulators (Leukine®, Neupogen®, Neulasta®) Note: Form must be completed in full. An incomplete form may be returned. Information on this form is p Passport Health Plan Medication Prior Authorization White Blood Cell Stimulators (Leukine®, Neupogen®, Neulasta®) Note: Form must be completed in full. An incomplete form may be returned. Information on this form is p](https://www.pdfsearch.io/img/ccbfa6230aea55166c9c80842c0727f2.jpg) | Add to Reading ListSource URL: www.passporthealthplan.comLanguage: English - Date: 2014-03-31 16:35:44
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183![Passport Health Plan Prior Authorization Zoladex® or Lupron® Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all privacy Passport Health Plan Prior Authorization Zoladex® or Lupron® Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all privacy](https://www.pdfsearch.io/img/c75d6fadf199e588a230759d8ffe0cb3.jpg) | Add to Reading ListSource URL: www.passporthealthplan.comLanguage: English - Date: 2014-03-31 16:36:38
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184![Passport Health Plan Medication Prior Authorization Request Form for Home Infusion Therapies Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health informa Passport Health Plan Medication Prior Authorization Request Form for Home Infusion Therapies Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health informa](https://www.pdfsearch.io/img/082eabf23544a923f6cbfa725ea452f1.jpg) | Add to Reading ListSource URL: www.passporthealthplan.comLanguage: English - Date: 2014-03-31 16:25:03
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185![Passport Health Plan Prior Authorization Form Aranesp® Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all privacy and s Passport Health Plan Prior Authorization Form Aranesp® Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all privacy and s](https://www.pdfsearch.io/img/9613714c3e1909de942f1dc27b7cad6c.jpg) | Add to Reading ListSource URL: www.passporthealthplan.comLanguage: English - Date: 2014-03-31 16:21:45
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186![Plan Year 2014 CCHP Senior Program (HMO) Prior Authorization (PA) Criteria Prior Authorization: CCHP Senior Program (HMO) requires you (or your physician) to get prior authorization for certain drugs. This means that you Plan Year 2014 CCHP Senior Program (HMO) Prior Authorization (PA) Criteria Prior Authorization: CCHP Senior Program (HMO) requires you (or your physician) to get prior authorization for certain drugs. This means that you](https://www.pdfsearch.io/img/eab3ac1dd1f9f48d1ba67e58394128a1.jpg) | Add to Reading ListSource URL: www.cchphmo.comLanguage: English - Date: 2014-09-26 15:55:16
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187![Passport Health Plan Prior Authorization Remicade® Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all privacy and securi Passport Health Plan Prior Authorization Remicade® Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all privacy and securi](https://www.pdfsearch.io/img/5399baf4e46293a551c77e30e107bc10.jpg) | Add to Reading ListSource URL: www.passporthealthplan.comLanguage: English - Date: 2014-03-31 16:26:53
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188![Passport Health Plan Prior Authorization Procrit® Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all privacy and securit Passport Health Plan Prior Authorization Procrit® Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all privacy and securit](https://www.pdfsearch.io/img/e6739692dcd1896509410ad9b7dfe054.jpg) | Add to Reading ListSource URL: www.passporthealthplan.comLanguage: English - Date: 2014-03-31 16:26:10
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189![Passport Health Plan Prior Authorization Tysabri® (natalizumab) Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all priva Passport Health Plan Prior Authorization Tysabri® (natalizumab) Note: Form must be completed in full. An incomplete form may be returned. Information on this form is protected health information and subject to all priva](https://www.pdfsearch.io/img/16b945263b6a4814230d2d5d5a4e2e14.jpg) | Add to Reading ListSource URL: www.passporthealthplan.comLanguage: English - Date: 2014-03-31 16:34:21
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190![2015 Chinese Community Health Plan Senior Program (HMO) Prior Authorization Criteria Last Updated[removed]Products Affected 2015 Chinese Community Health Plan Senior Program (HMO) Prior Authorization Criteria Last Updated[removed]Products Affected](https://www.pdfsearch.io/img/19e70f078179ef3b0638f180f611edd7.jpg) | Add to Reading ListSource URL: www.cchphmo.comLanguage: English - Date: 2014-10-30 19:57:30
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