Prior authorization fax form pdf 2025

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The document is a fax cover sheet and instructions for submitting a Prior Authorization Request to Baylor Scott & White Health's Health Services Department. It outlines the necessary information required for processing, including details about the requesting and servicing providers, clinical documentation, and specific types of medical services or drugs being requested. The document emphasizes the importance of providing complete and legible information to avoid delays in authorization.

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Can you fax a prescription to Express Scripts?

E-PRESCRIBING OR FAX | The easiest way to enjoy the convenience of home delivery is to ask your provider to send your prescription(s) electronically to Express Scripts Pharmacy . Your provider can also fax your prescription to Express Scripts Pharmacy they can call (888) 327-9791 for faxing instructions.

What is the fax number for Express Scripts prior authorization form?

After the form has been completed, it can be faxed to Express Scripts at 1-877-251-5896 for review. Express Scripts will notify your doctor of the approval or denial within 48 hours of receipt of the prior authorization form. Electronic Prior Authorization.

What is the fax number for Optumrx prior authorization form?

Please have the doctor or a qualified member of the office staff complete the next page(s) and fax the completed form to 1-844-403-1024. If you have questions or want to speak with an Optum Rx Prior Authorization Advocate, call 1-800-711-4555.

What is the fax number for Express Scripts prior authorization?

After the form has been completed, it can be faxed to Express Scripts at 1-877-251-5896 for review.

What is the fax number for prior authorization for FEP?

Fax numbers for prior authorizations 877-404-6455 or 888-368-3406 (fax along with a Recommended Clinical Review (Predetermination) form).