Emergency Medication Override
After hours, weekends and holidays, at the professional judgment of the dispensing pharmacist, a 3 day emergency supply of the medication may be dispensed for the alleviation of severe pain and the treatment of unforeseen medical conditions, which, if not treated immediately would lead to disability or death.
Pharmacy instructions for billing an emergency supply:
- Update the quantity of medication to the calculated amount for a 3-day supply (e.g., if the direction say take 1 tablet 3-times a day, 3 tabs per day x 3 days = 9 tablets)
- In the Prior Authorization field enter the code: 9999998
- Dispense the medication once a paid claim has been received
- Submit a prior authorization request to the HPSJ to request coverage of additional supply beyond the initial 3 days.
- Prior Authorization may be requested by telephone to Utilization Management Department at 209-942-6350, fax to 209-762-4702 (San Joaquin County), or 209-762-4703 (Stanislaus County), mail or electronic submission.
Restrictions on use of the emergency medication override
- Code is only available Monday-Friday from 5:00pm to 6:00am and all day weekends and holidays.
- This override is only valid for medications that are non-formulary or require prior authorization/step therapy.