Caremark Speciality Drugs Prior Authorization

• Caremark Specialty Enrollment (PDF)
• Adult and Pediatric Endocrine (PDF)
• Allergic Asthma (PDF)
• Alpha1 Antitrypsin Deficiency (PDF)
• Crohns Disease (PDF)
• Hematopoietics (PDF)
• Hemophilia and Related Bleeding Disorders (PDF)
• Hepatitis C (PDF)
• Immune Disorders (PDF)
• Intravenous Immune Globulin IVIG (PDF)
• Lysosomal Storgae Disorders (PDF)
• Macular Degeneration (PDF)
• Multiple Sclerosis (PDF)
• Oncology (PDF)
• Osteoarthritis (PDF)
• Pediatric Endocrine (PDF)
• Psoriasis (PDF)
• Psoriatic Arthritis (PDF)
• Pulmonary Arterial Hypertension (PDF)
• Respiratory Synctial Virus RSV (PDF)
• Rheumatoid Arthritis (PDF)
• Sensipar (PDF)

Claim and Authorization

• Claim Form Announcement (PDF)
• NJ EPSDT Exam Forms
• Prior Authorization Medication Request (PDF)

For information regarding the following, please refer to the UHP Provider Office Manual:

• Billing Information and Guidelines
• Lead Screening
• Prior Authorization Medication Request Form
• Claims Requiring Information
• Ambulatory Medical Record Review (AMRR)
• Provider Grievance Process
• WIC Referral Form