Information for Providers
US Family Health Plan is committed to giving providers the information and tools they need. Toward that end, we are developing this online resource section for our network providers. For questions about US Family Health Plan, or to schedule a provider orientation, please contact Billy Partain , Provider Network Coordinator, at 617-562-5548, or at Billy_Partain@usfamilyhealth.org .
Provider Information:
Provider Newsletter:
- Provider Newsletter Fall 2007 Issue
- Provider Newsletter, Spring 2007 Issue
- Provider Newsletter, Summer 2005 Issue
Provider Pharmacy Information
• TRICARE Uniform Formulary and Non-Formulary Medications
Medical Necessity Forms for Non-Formulary Medications:
To download a medical necessity form for a non-formulary medication, please click on the appropriate link below:
- ACE Inhibitor / CCB Combination Products (Lexxel & Tarka)
- ACE Inhibitors and ACE Inhibitor/HCTZ Combination Products
- Atorvastatin / Amlodipine (Caduet)
- Cialis (Tadalafil) and Viagra (Sildenafil)
- Cymbalta (Duloxetine)
- Dihydropyridine Calcium Channel Blockers
- Eprosartan (Teveten) & Eprosartan/HCTZ (Teveten HCT)
- Esomeprazole (Nexium)
- Ketek (telithromycin) and Zmax (azithromycin sustained release suspension)
- Lexapro (escitalopram)
- Lyrica (Pregabalin)
- Nasal Corticosteroids
- Overactive Bladder (OAB) Medications
- Paxil CR, Prozac Weekly, Sarafem, and Wellbutrin XL
- Rosuvastatin (Crestor)
- Tacrine (Cognex)
- Tamsulosin (Flomax)
- Topical Antifungals
- Verelan, Verelan PM, Covera HS, and Cardizem LA
Prior Authorization Forms for Non-Formulary Medications
To download a prior authorization form for a non-formulary medication, please click on the appropriate link below:
- Adalimumab (Humira)
- Anakinra (Kineret)
- Efalizumab (Raptiva)
- Etanercept (Enbrel)
- Fertility Agents (Injectable Gonadotropins Only)
- Growth Hormone
- Mecasermin (Increlex)
- PDE-5 Inhibitor
- Pramlintide (Symlin)
- Terbinafine (Lamisil), Itraconazole (Sporanox), Ciclopirox (Penlac)
Please let us know if you have any suggestions for other materials you would like added to this section.
