Français
Home
Provider Registry
Secure Services
What You Need
About Us
Contact Us
Pharmacy
Health Professional
Non-Health or Accommodation
Dental Provider
Extended Health Service Provider
Pharmacy Provider
Send A Form Or Document
Drug Authorization Forms
GSC
MÉDIC Construction (CCQ)
A Drug Special Authorization form is required when a pharmacy receives a denial for an electronic drug claim that requires prior authorization. The pharmacy will receive a message indicating that the drug must be authorized. The pharmacy can then print the appropriate form(s) that corresponds to the special authorization drug. This form must be given to the plan member to be completed by their physician and returned to Green Shield Canada for assessment.
Display Using
-- Select --
Brand Name
Generic Name
Search by name
- Or Search by alphabetic listing -
A Drug Special Authorization form is required when a pharmacy receives a denial for an electronic drug claim that requires prior authorization. The pharmacy will receive a message indicating that the drug must be authorized. The pharmacy can then print the appropriate form(s) that corresponds to the special authorization drug. This form must be given to the plan member to be completed by their physician and returned to MÉDIC Construction (CCQ) for assessment.
Display Using
-- Select --
Brand Name
Generic Name
Search by name
- Or Search by alphabetic listing -
Requires Adobe Acrobat Reader
© 2021 providerConnect™
LEGAL
PRIVACY
SECURITY
TECHNICAL SUPPORT