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Step 2: Submit the Prior Authorization Request Follow up and confirm with your insurance company that the request was received. Ensure no forms or required documents are missing. Be aware of your insurers response timeframe, typically 7-14 days.
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.
Request Expedited Reviews from the Payer for Urgent Cases Healthcare providers must request an expedited review to speed up the prior authorization for urgent medication cases. If a patients condition requires immediate attention, healthcare providers must contact the payer to address the issue.
Your doctor can initiate the prior authorization process by calling Express Scripts toll-free at 800‑417‑8164 or by fax at 800‑357‑9577. If you plan to fill your prescription at a retail pharmacy, consider completing the prior authorization with your doctor before you go to the pharmacy.
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.
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