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Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Statewide Initiatives



211 - Get Connected. Get Answers.

Standard Pharmacy Prior Authorization Form for Prepaid Health Plans Is Live

Wednesday, May 29, 2013  |  Contact: Bayou Health (225) 342-7878

All Bayou Health Prepaid Plans now accept a standard single page prior authorization form for outpatient pharmacy services. The purpose of the form is to streamline and simplify the pharmacy prior authorization process for providers who contract with multiple Bayou Health Prepaid Plans. The standard form is a complement to Plans' existing prior authorization processes, which providers may continue to use. The form is available on each Prepaid Health Plan's website, along with instructions for its use.

Pharmacy Prior Authorization Form