- The physician must complete the prior authorization form and send it to SAV-RX for review. The form can be faxed to: 1 (888) 810-1394
- Not all prior authorization requests will be approved. The patient may have to choose between paying for the drug out of pocket or going with a cheaper medication.
SAV-RX Prior (Rx) Authorization Form
An SAV-RX prior authorization form is used by prescribing physicians to request a specific drug treatment plan for their patient that is not usually covered by insurance. The doctor must disclose their medical reasoning for prescribing the patient this particular drug instead of cheaper alternatives.
Updated November 15, 2024
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