Synagis Prior Authorization
A Step-by-Step Prescribing Guide for CHP+ offered by Colorado Access Providers
Please use the following guide to help you order Synagis for your patient.
- Please complete the Synagis Prior Authorization form and prescription for Synagis for each patient and fax to Avella pharmacy at 877-470-7604. If the infant will need the medication to be administered at home, please indicate this on the form.
- For all infants meeting criteria, we will set up an authorization in our system for Avella and for the provider who will be administering the Synagis. A letter of authorization will be faxed to the provider.
- Avella will call you to get detailed information about the infant for each dose to be administered.
- Avella will ship the product to the provider’s office or to the patient’s home for administration and will bill Colorado Access directly.
If you have questions regarding this process, please contact:
- Colorado Access Pharmacy Services at 303-751-9005 (800-511-5010) or
- Avella at 877-470-7603