PDL Drug Prior Authorization Forms



KanCare Information
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Please refer to the following KMAP Provider manuals for PA process details:

  • For Pharmacy claims refer to the Pharmacy manual
  • For Professional claims refer to the General Special Requirements manual
     
    KMAP (Fee For Service) PA Call Center
    Phone:  800-285-4978
                785-274-5956
    Fax:      800-913-2299
    Hours: Mon. – Fri.
                7:30a.m. – 5:30p.m.

PA Forms for PDL Drugs (listed by class)

Clinical PA Forms