Include the drug dose, route and frequency in the first field, the start and stop dates in the second and third, as well as the detailed outcome in the forth. Step 5 – Past/present therapies which have been prescribed should be indicated in this window. The current diagnosis and pertinent medical history can be supplied in the third line, while all other tests, x-rays and the like can be detailed in the fourth field. Enter the name of the medication requested and indicate whether or not the drug should be “Brand name only.” The rationale for the non-preferred drug can be provided in the second line. Step 4 – Here is where the medical rationale for prescribing the non-preferred drug can be supplied. Step 3 – If applicable, fill in the “Medical Benefit Requests Only” window with the following information: Step 2 – The first information required pertains to the member for whom coverage is being requested, as well as the individual prescribing the drug in question. She is also the author of the critically-acclaimed novel, The Matrimonial Flirtations of Emma Kaulfield, and the founder of XOFeminist Productions, a multi-media company dedicated to producing original, innovative feminist content in film and theater.Fidelis Prior Prescription Authorization Form
Her other films include, The Love Bathroom, Swallow Your Money, and Love and Loathing.
#FIDELIA NYC HOW TO#
She is directing and starring in a futuristic feminist TV comedy series, Social Disasters 360, and is in pre-production on a feature film, How To Seduce Your Dinner Guest.
She directed and starred in Invisible Alice, a short musical film, which won for best musical at the Action on Film Festival in Las Vegas, and won for best director at the International Film Festival Milan in 2017. She wrote and starred in the award winning web series, Happy Hour Feminism (2015-2016), which won awards for leading actress, women filmmakers, best screenplay, best web series, best short comedy, best musical parody, and has been selected at over 17 festivals. Her solo cabaret show, Anna on Fire and Uncensored, played at the Metropolitan Room in New York City in 2017 and was recommended by CBS Local News New York, Jewish Week, and NiteLife NYC. WCBS Radio called Anna "a comic genius" and Jewish Week compared Sex in Mommyville to Ibsen's "A Doll's House." Her second play, My Stubborn Tongue, played off-Broadway at the New Ohio Theatre, NYC in 2014 and went on to play on West End in London at the Soho Theatre in 2015, at Pushkin House London in 2016, and was recommended by The London Evening Standard. Her first play, Sex in Mommyville, premiered at the Flea Theater in New York City in August 2010, and was recommended by Bloomberg News. Anna is the founder of XOFeminist Productions, a multi-media company dedicated to producing original, innovative feminist content in film and theater.Īnna Fishbeyn is an actress, writer, director and filmmaker. Anna won An Award of Recognition for Leading Actress for her work as Anna, the hostess of Happy Hour Feminism. She wrote and starred in the web series, Happy Hour Feminism, which has been nominated and officially selected at numerous film festivals, including The Los Angeles Independent Film Festival Awards, Ocktober Film Festival, Miami Independent Film Festival, Action on Film International Film Festival, the IndieFest Film Awards and many others. Bloomberg News recommended the play, WCBS Radio called Anna "a comic genius," and Jewish Week compared the play to Ibsen's "A Doll's House." Anna studied acting at HB Studio under Austin Pendleton, and voice with Ingrid Zeldin and Anya Fidelia, Her second play, My Stubborn Tongue, opened off-Broadway at the New Ohio Theatre, NYC, and went on to play at the United Solo Festival on Theatre Row, NYC, and on West End in London at the Soho Theatre. She wrote and starred in her first play, Sex in Mommyville, at the Flea Theater in NYC in August, 2010. from Columbia University, and her MFA in fiction writing from New School University. She received her Bachelor's Degree from the University of Chicago, a Ph.D. Anna quickly became fluent in English and began to pass as an American. Her family fled the former Soviet Union as political refugees when Anna was a small child, and found a home in Chicago. Anna Fishbeyn was born in Moscow, Russia, behind the Iron Curtain.
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