A formulary is a list of prescription drugs that PHP encourages our doctors to prescribe when appropriate. This formulary was developed with the help of area doctors and pharmacists. The formulary is updated quarterly and may change at any time.
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PHP is licensed to sell products and services in 40 Northern Indiana counties (statewide for TPA services). Additionally, PHP's Provider Network extends beyond this service area to provide…
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Health plans use formularies to manage the cost of pharmaceutical healthcare. Formulary guidelines and protocols are used to encourage doctors to prescribe according to a predetermined therapeutic strategy developed by local health professionals.
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Some medications require the use of an alternate prescription drug within a specified number of days before they can be covered. This alternate prescription process is referred to as Step Therapy.
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Certain medications have a status of Prior Authorization Required (PAR). If your doctor wants to prescribe a PAR drug, he or she will submit a request for approval before the drug can be dispensed as a covered benefit. If your pharmacist receives notification that a drug you were prescribed requires prior authorization, ask your pharmacist to contact us.
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Our Customer Service Department can provide drug formulary information, or you may check for formulary information listed at www.phpni.com. All PHP participating doctors and pharmacies automatically receive a copy of the drug formulary each year along with updates throughout the year.
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Some medications may be subject to quantity level limits based on the manufacturer's packaging insert. These Quantity Limits are designated in the Drug Formulary by (QL) next to the medication name. The purpose of these maximum quantity limits is to ensure the proper billing of products. It also encourages the use of therapeutically indicated medication regimens.
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