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Medical Pre-authorization

Pharmacy Prior Authorization Information

  • Pharmacy prior authorization information, Preferred Medication List and forms can be found at the RegenceRx
  • Pharmacy inquiries should be directed to:
    • Phone - 1 (800) 643-5918
    • Fax - 1 (800) 884-4282
Important prior authorization reminders:
  1. Before requesting prior authorization, please verify eligibility, benefits and medically managed delegation services through Customer Service.
  2. Verification of member eligibility is valid if obtained within five business days of the service except in the case of a misrepresentation.
  3. Member contracts determine benefits. Contract exclusions will not be prior authorized. Denials may be appealed through Customer Service.
  4. Prior authorization obtained within 90 business days prior to the service is valid except in the case of a misrepresentation.
  5. Medication policies related to specific prior authorization requirements may be available online.

 

 

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