Medical Prior Authorization Request (PAR) for Synagis®

 

The 2016-2017 Synagis® season will begin November 30, 2016 and end April 30, 2017

Effective December 1 2016, the Colorado Medical Assistance Program will begin accepting PARs for Synagis®. All requests for Synagis® (Palivizumab) require a PAR.

Process for Submitting PARs

Providers can submit Medical Synagis® PAR requests to eQHealth Solutions starting December 1, 2016.

To begin please this process, please complete the Request for eQSuite Access Form

For step by step instructions for submitting a PAR through eQSuite, please review

Provider Guide – Synagis® PARs

Presentation - Synagis® PARs

OR

Listen to a recorded webinar for eQSuite Training by clicking on the link below.


 



Please note:

All PAR's must be submitted via eQSuite® PAR portal 

Provider may request an exception to the requirement if:

1. The provider is out-of-state, or the request is for an out-of area service;

2. The provider submits, on average, five or fewer PARs per month and would prefer to submit a PAR by telephone or facsimile’

3. The provider is visually impaired.

If you meet these requirements please complete the eQSuite® Exception Request Form

You will receive an email confirming that you have been approved to submit via Fax, please use the following PAR Form to submit your PAR.

Synagis FAXED PAR Form 2016


Click the link below to view the Department's (HCPF) Provider Bulletin for more information:
Synagis® Provider Bulletin