P-17. Documents
Clinical Prior Authorization Documents
Refer to the Medicaid Clinical Prior Authorization section to learn more.
Enrollment Documents
| Document Name |
|---|
Pharmacy Delivery Signage - Grayscale (PDF)
|
Pharmacy Delivery Signage - Full color (PDF)
|
Outreach and Education Documents
Refer to the Pharmacy Education Downloadable Materials for more information about these documents.
| Document Name | Revision |
|---|---|
| Dispensing 72-hour Emergency Prescriptions Instructions (PDF) | July 2019 |
| Find the Formulary on Epocrates (PDF) | July 2022 |
| Managed Care Complaint Process (PDF) | May 2023 |
| Medicaid Formulary Information (PDF) | July 2022 |
| Mosquito Repellent Benefit Information (PDF) for pharmacies | May 2022 |
| Mosquito Repellent Benefit Information (PDF) for clients (English) | June 2022 |
| Mosquito Repellent Benefit Information (PDF) for clients (Spanish) | June 2022 |
| Pharmacy Claim Submission For Commercial Insurance (PDF) | Sept. 2023 |
| Pharmacy Claim Submission For Medicare Part B (PDF) | Sept. 2023 |
| Pharmacy Claim Submission For Medicare Part D (PDF) (double-sided) | Sept. 2023 |
| Provider Enrollment and Management System (PDF) | May 2022 |
| Real-time Eligibility Verification Information (PDF) | July 2019 |
Preferred Drug Documents
Refer to the Medicaid Non-preferred Prior Authorization section for more information. Refer to the Preferred Drug List Process to learn how HHSC includes drugs on the PDL.