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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
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If your request for prescription coverage was denied, you have the right to ask for a redetermination (appeal) of our decision. If youre an Express Scripts member, log in to your account before filling out this form. Did the doctor requesting this appeal also prescribe the medication?
If your prescription requires prior authorization, you or your doctor can initiate the prior authorization review by calling Express Scripts at 1-800-753-2851. Express Scripts will inform you and your doctor in writing of the coverage decision.
Express Scripts prior authorization phone lines are open 24 hours a day, seven days a week, so a determination can be made right away. If the information provided meets your plans requirements, you pay the plans copayment at the pharmacy.
To request pre-authorization: Download a Compound Drug Pre-Authorization Form or contact Express Scripts to get the form. Give it to your doctor to complete and submit to Express Scripts. (Instructions are on the form.)
The patient or their representative can contact their insurance company and provide the relevant information to start the Prior Authorization process. Its best to confirm with the healthcare provider if they have the information and are willing to submit the request.
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People also ask

You may also ask us for an appeal through our website at .Express-Scripts.com. Expedited appeal requests can be made by phone at 1.800. 935.6103, (TTY users can call 1.800. 716.3231), 24 hours a day, 7 days a week (including holidays).

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