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Please call us at 800.753. 2851 to submit a verbal prior authorization request if you are unable to use Electronic Prior Authorization. Prior Authorization criteria is available upon request.
Please call us at 800.753. 2851 to submit a verbal prior authorization request if you are unable to use Electronic Prior Authorization. Prior Authorization criteria is available upon request.
Prior authorization ensures that you get the prescription drug that is right for you and that is covered by your benefit. If it's determined that your plan doesn't cover the drug you were prescribed, you can ask your doctor about getting another prescription that is covered. You'll receive it for your plan's copayment.
We've partnered with CoverMyMeds® and Surescripts®, making it easy for you to access electronic prior authorization (ePA) via the ePA vendor of your choice.
Prior authorization\u2014sometimes called precertification or prior approval\u2014is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.
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Prior authorization ensures that you get the prescription drug that is right for you and that is covered by your benefit. If it's determined that your plan doesn't cover the drug you were prescribed, you can ask your doctor about getting another prescription that is covered. You'll receive it for your plan's copayment.
When your pharmacist tells you that your prescription needs a prior authorization, it simply means that more information is needed to see if your plan covers the drug. Only your doctor can provide this information and request a prior authorization. 2.
Solving a very acute and painful problem, CoverMyMeds counts some of the biggest names in healthcare among their users. They work with pharmacies like Walgreens and Rite Aid, within retail pharmacies at chains like Wal-Mart, Giant Eagle, Costco, Publix and Kmart, as well as mom-and-pop shops.
If your physician's office calls with all relevant medical information including member name, member ID number, diagnosis and past medication history, we may be able to provide a prior authorization decision during the call. If the request is faxed, it may take up to 24 to 72 hours for a decision.
If a PA is needed, locate the process for submitting and obtain any required prior authorization forms. This information is typically found on the plan's website, or you may call the member services number found on the back of your insurance card.

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