What type of information is required for specialty medications in a prior authorization claim?

For specialty medications in a prior authorization claim, specific clinical information is typically required to ensure that the medication is medically necessary and to help the insurer determine if it meets their guidelines for coverage. A PPD test (Purified Protein Derivative test) is related to screening for tuberculosis and can be relevant in the context of certain specialty medications that may suppress the immune system or are used in treating conditions that require such screening.

This type of information helps providers and insurers assess the patient's health status, the appropriateness of the prescribed therapy, and possible risks associated with the medication. In contrast, other options like blood type, family history, or an insurance deductible may not directly relate to the clinical necessity of initiating treatment with a specialty medication and are therefore not typically required for prior authorization in this context.