Requests for Out of Network Pharmacy Services

April 2022

Neighborhood has a broad network of providers and engages members and their providers to evaluate the availability of necessary services within the local delivery system.

  • Neighborhood evaluates the medical necessity of requests for pharmacy services from out-of-network practitioners/ providers.

If you are requesting pharmacy services from an out-of-network provider, please complete the General Prior Authorization for Drugs Administered in Office Form and return it via fax to Neighborhood’s Pharmacy Department at 1-844-639-7906.  Please include the clinical rationale as to why the service(s) are required to be rendered by an out-of-network provider.


Last updated: April 6, 2022 @ 2:58 pm