Purpose of the Peer-to-Peer (P2P)
Criteria for Request
If you would like to request a P2P to discuss the denial of a physician-administered medication, please submit the Pharmacy Peer-to-Peer Review Request Form.
If the request does not meet these criteria and you wish to submit an appeal, please refer to the denial letter.
Fields marked with an asterisk (*) are required fields.
Note: New information about the service must be submitted as an appeal.
Note: Additional P2Ps are ONLY allowed for new/different denial on current reviews (i.e., a request to extend an inpatient hospital stay).
Note: P2P requests for Medicare members will be considered regardless of whether an appeal has been submitted or not.
(e.g. ok to leave message, ask for specific person)