New Illinois Uniform Electronic Prior Authorization Form For Prescription Benefits
Posted June 30, 2021
The Illinois Department of Insurance (IDOI) has released a uniform electronic prior authorization form for prescription drug benefits to be used by commercial insurers.
The Illinois Uniform Electronic Prior Authorization Form for Prescription Benefits is available on our Forms page under the Pharmacy category. Complete instructions are included on the form.
This information does not apply to requests for government programs (Medicare Advantage and Illinois Medicaid) members.
Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider.