Instructions * What are you using to track your patients refill date? A white board or paper solution Electronic calendar (like Outlook) or spreadsheet Retail pharmacy software Specialty pharmacy software Other What do you use to track whether authorizations are received, when they need to be renewed and/or when they are expiring? A white board or paper solution Electronic calendar (like Outlook) or spreadsheet Retail pharmacy software Specialty pharmacy software Other How are you locating the correct prior authorization form? Printed paper forms kept in large binder Payor website Prior Authorization websites Dr. handles all prior authorizations Other What percentage of referrals are you unable to provide for? 0-5% 5-15% 15-25% 25%+
