Medical Prior Authorization Request (PAR) for Synagis®

 

The 2019-2020 Synagis® season will begin December 2, 2019 and end April 30, 2020

Effective November 18, 2019, the Colorado Medical Assistance Program will begin accepting PARs for Synagis®. All requests for Synagis® (Palivizumab) require a PAR, for dates beginning December 2, 2019, to April 30, 2020.

Process for Submitting PARs

Providers can submit Medical Synagis® PAR requests to eQHealth Solutions starting November 26, 2018.

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

Synagis® e
QSuite® User Guide





OR

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


 Presentations & Video Tutorials

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® Pharmacy Benefit Prior Authorization Request Form


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