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Pre-authorization

Pharmacy Prior Authorization Information

  • Pharmacy prior authorization information, Preferred Medication List and forms can be found at RegenceRx.
  • Questions for RegenceRx should be directed to:
    Phone: 1 (800) 732-9157  
         
    Fax: 1 (800) 884-1053  
         
    Phone: Medicare 1 (888) 437-1508
         
    Fax: Medicare Part D: 1 (888) 335-3016
Important prior authorization reminders:
  • Before requesting prior authorization, please verify eligibility, benefits and medically managed delegation services through Customer Service.
  • Verification of member eligibility is valid if obtained within five business days of the service except in the case of a misrepresentation.
  • Member contracts determine benefits. Contract exclusions will not be prior authorized. Denials may be appealed through Customer Service.
  • Prior authorization obtained within 90 business days prior to the service is valid except in the case of a misrepresentation.
  • Medication policies related to specific prior authorization requirements may be available online.

 

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