
Express Scripts is a leading pharmacy benefit manager that requires prior authorization for certain medications. You can fax the prior authorization request to 1-800-467-4825.
To get started, you'll need to gather the necessary information, which includes the patient's name, date of birth, and Medicare ID number. Express Scripts also requires a valid reason for the medication, so be sure to include that in your request.
Express Scripts has a dedicated team that reviews prior authorization requests. They typically respond within 24-48 hours, but this timeframe may vary depending on the complexity of the request.
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What is Express Scripts
Express Scripts is a pharmacy benefit manager (PBM) that helps manage prescription medication costs for health plans, employers, and government programs. They provide a range of services to help patients get the medications they need.
Express Scripts was founded in 1986 and has since grown to become one of the largest PBMs in the US, serving over 80 million people. They process over 1 billion prescriptions annually.
Express Scripts offers a variety of services, including prior authorization, which is a process to ensure that certain medications are medically necessary before they can be filled.
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Express Scripts Overview
Express Scripts is a leading pharmacy benefit manager (PBM) that helps people get the medications they need to live healthier lives.
Express Scripts was founded in 1986 by George Paz and was later acquired by Cigna in 2018.
The company manages pharmacy benefits for millions of people through its network of pharmacies, clinics, and other healthcare providers.
Express Scripts has a vast network of over 68,000 pharmacies, including retail pharmacies, mail-order pharmacies, and specialty pharmacies.
It also offers a range of services, including medication therapy management, disease management, and health and wellness programs.
Express Scripts has a strong commitment to innovation, with a focus on using technology to improve the healthcare experience.
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Express Scripts Benefits
Express Scripts offers a range of benefits to its members, including access to a vast pharmacy network.
With over 65,000 participating pharmacies, you can get your prescriptions filled at a location near you.
Express Scripts also offers a 24/7 customer service hotline, so you can get help whenever you need it.
Members can also take advantage of online tools and resources, such as the Express Scripts website and mobile app, to manage their prescriptions and stay on top of their health.
By using Express Scripts, you can save money on your prescriptions through discounts and promotions.
Express Scripts also helps members stay healthy by providing resources and tools to manage chronic conditions and prevent disease.
Additionally, Express Scripts offers a patient assistance program to help low-income individuals access the medications they need.
Pharmacy Services Overview
You can contact Pharmacy Services for prior authorization at 1-866-716-5099. They're available to take your call Monday through Friday from 7 a.m. to 5 p.m. Pacific Standard Time.
The clinical hours for Pharmacy Services are Monday through Friday from 7 a.m. to 5 p.m. Pacific Standard Time.
To get help with a prior authorization request, you can call the Pharmacy Services help desk at 1-877-250-6176.
Pharmacy Services will respond to your prior authorization request via fax or phone within 24 hours of receiving your request.
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Prior Authorization Process
The prior authorization process can be a hassle, but understanding how it works can make it more manageable. Express Scripts requires a prior authorization for certain medications, which means you'll need to get approval before filling your prescription.
To start the process, you'll need to submit a request to Express Scripts, either online, by phone, or by fax. Express Scripts' prior authorization fax number is 1-800-467-4701, which is a convenient option for those who prefer to fax their requests.
Additional reading: Prior Authorization Process Flow Chart
Prior Authorization Requirements
Prior Authorization Requirements can be lengthy and complex, but understanding them is crucial for a smooth process. The requirements often vary by payer, with some requiring more documentation than others.
In most cases, a prior authorization request must include the patient's demographic information, medical history, and diagnosis. This is typically done by the healthcare provider.
A treatment plan or a clinical protocol is usually required to justify the requested treatment. The plan should outline the treatment's expected outcomes and the patient's potential risks.
Payers often have specific requirements for the format and content of prior authorization requests. For example, some may require electronic submissions, while others may accept paper requests.
The timeframe for receiving a prior authorization decision can range from a few hours to several days, depending on the payer and the complexity of the case. It's essential to check with the payer for their specific requirements.
Prior Authorization Fax Number
To get a prior authorization, you'll need to contact the payer's prior authorization fax number, which can be found on the payer's website or by calling their customer service number.
The fax number is usually a dedicated line for prior authorization requests, and it's essential to use the correct number to avoid delays in processing your request.
You can find the payer's fax number by checking their website, which is usually listed under the "Contact Us" or "Prior Authorization" section.
Some payers may also require you to submit your request through their online portal, but faxing is still a common method used by many providers.
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Express Scripts Phone Number
If you need to contact Express Scripts for prior authorization, you can call them at 1-877-378-1556.
Express Scripts has a dedicated customer service team that can assist you with prior authorization requests, including answering questions and providing updates on the status of your request.
The Express Scripts phone number is available 24/7, so you can reach out to them at any time to get help with your prior authorization needs.
Express Scripts also offers a secure online portal where you can submit prior authorization requests and track their progress.
Express Scripts Fax Number
If you need to contact Express Scripts for prior authorization, you can reach out to them at 1-800-467-4702. Express Scripts also offers a fax number, 1-800-467-4702, for those who prefer to communicate through fax.
Express Scripts is a pharmacy benefit manager that handles prior authorizations for many insurance plans. This process can be complex and time-consuming, but having the right contact information can make a big difference.
You can also submit prior authorization requests online through the Express Scripts website. The website provides a secure and convenient way to submit requests and track their status.
If you have any issues with the online submission process, you can contact Express Scripts customer service for assistance. They are available to help with any questions or concerns you may have.
Frequently Asked Questions
How do I fax a prescription to Express Scripts?
To fax a prescription to Express Scripts, your provider must call (888) 327-9791 for faxing instructions and provide your member ID number. Only authorized providers can fax prescriptions to Express Scripts.
Sources
- https://militaryrx.express-scripts.com/healthcare-providers-prescribers
- https://www.pahealthwellness.com/providers/pharmacy.html
- https://www.coordinatedcarehealth.com/members/medicaid/benefits-services/pharmacy.html
- https://www.absolutetotalcare.com/providers/pharmacy.html
- https://www.pa.gov/agencies/dhs/resources/pharmacy-services/pharmacy-services-fax-forms.html
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