SH16-006 Interagency Contract - Laserfiche WebLink

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• From 8 a.m. - 4:30 p.m. Monday —Friday (except holidays), the Nurse Desk is available at NurseDesk@docl.wa.gov or (360) 725-8733. • After normal business hours and during holidays, please call (360) 725-8733. The call is forwarded to the on-call UM Nurse. Emails may not be returned until the next business day. Denials - If the Department denies the authorization for extraordinary medical care, Contractor(s) may appeal the Department's decision by submitting a written request with the supporting documentation to the Department's Utilization Management Office at NurseDesk@docl.wa.gov. Pharmaceuticals and Non -Formulary Requests The Department may reimburse for prescription medications that are consistent with the Offender Health Plan and Formulary. Restricted formulary and non -Formulary medication must be pre -authorized by submitting a request to the Department's Utilization Management Office either via email at NurseDesk@docl.wa.gov or fax at 360-586-9060. The non -formulary request (NFR) form is available online at: http://www.doc.wa.ggv/family/offenderlife/docs/DOC13-091.12df . Formulary medications are medically necessary medications that require no further Department approval for use, provided the criteria listed in the Department's Formulary are met. Preauthorization —Restricted Formulary and non -Formulary medications may be prescribed however, the Department will only authorize these medications if the specific criteria necessary for approval are met. Medications in this category require preauthorization by the Department's Utilization Management Office to be considered for reimbursement. When a Contractor determines that the administration of a restricted Formulary or a non - Formulary medication is medically necessary for the continuous management of a significant medical or mental health condition, the Contractor should proceed based on his/her professional clinical judgment. However, to be considered for reimbursement, a restricted Formulary/non-Formulary medication request must be approved by the Department's Utilization Management Office as soon as feasible, but not later than 3 days after beginning the medication. Denials - If the Department denies the request to use restricted Formulary medication and/or non -Formulary medication, the Contractor may still be reimbursed for medications administered to a Department offender while awaiting the Department's decision on the State of Washington K9561 (4) Page 21 of 25 Department of Corrections 158362