Workers' Compensation Pharmaceuticals: Prior Authorization, High Dollar Rejections and Brand to Generic Guidebook
Information on some of the most commonly prescribed medications in workers’ compensation. Claims professionals can use this guidebook as a resource that provides easy access to information regarding indications, generic availability and possible alternatives.
A key benefit of the guidebook to claims professionals is that information can be used when contacting a prescriber to determine if drugs on the list of alternatives have been tried. If the prescriber has attempted at least one of the other medications, the claims professional can feel more confident in approving the medication as the decision was supported with clinical evidence.
Medications are listed alphabetically in the guidebook by generic name with the brand version beneath. This is modified from the industry standard of listing the brand version first to better reflect that the majority of drugs dispensed are now generic. This guidebook is solely for reference purposes and is not intended, nor should be used or relied upon for the purposes of prescribing or using a product. The trademarks and other product names listed in this guide are the property of their respective companies.
myMatrixx's clinical team is available to answer questions related to a patient’s medication regimen. In some instances, a recommendation may be made to conduct a One Drug Review or a more comprehensive Clinical and Safety Evaluation (CASE Rx)SM. Both of these products feature outreach to the prescriber to discuss the use of alternative medications and they may incur a charge.