Billing L&I for Pharmacy Services

How to obtain authorization

What information is needed before calling for authorization:

  • Injured worker’s claim number
  • Pharmacy’s L&I provider account number or prescribers’ L&I provider account number or license number
  • Drug name and NDC
  • Condition the drug will be used to treat

Who to call:

Call PDL hotline: 1−888−443−6798 or 360−902−4321 Monday through Friday, 8 a.m. to 5 p.m. PT.

PDL or First Fills Non-preferred Drug Requests:

  • If the pharmacy receives a prescription after normal business hours or during weekends or Washington State holidays, you may:
    • Dispense the drug under the worker's primary insurance or straight cash transaction and request authorization the next business day.
    • Dispense an emergency supply of the drug (enter a value of 6 in the DAW field) and request authorization the next business day.  L&I considers an emergency supply for most drugs, up to 10 days.
  • When you call L&I, you will need to give a diagnosis, or information on the condition being treated.

 

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