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Physician Innovation

We help 1.4 million physicians and their office staff make optimized prescribing decisions by providing a more complete view of the patient, enabling greater opportunities for whole person health. Our data-driven tools and technologies help remove barriers to care, increase member savings and offer a simpler, better experience for our members, physicians and their staff and patients.
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Streamlining care with innovative solutions

Physicians want to focus on patients, not paperwork. That’s why we’ve partnered with them to develop Physician Innovations, that integrate with electronic health record (EHR) systems and enable prescribers to make better clinical and cost-effective decisions for patients – in real time.

The Physician Innovation suite is integrated with many EHR systems, allowing you to get started immediately. If you determine you need access, contact your EHR or IT administrator for a system upgrade.

Our key vendor partners include Arrive Health, CenterX, SureScripts and more.
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Real-time data
Get important patient benefit data prior to e-Prescribing. View patient out-of-pocket costs, coverage alerts and therapeutic options that can save the patient money. For you, this digital tool removes the guesswork, saves time, and enables you to get back to what matters most — caring for your patients.
Improve clinical outcomes
With immediate access to patient-specific information like adherence alerts within your electronic health record, you are empowered to better plan before your patient visit and make more informed decisions during your patient visit right in the exam room when you’re still with them.
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Reduce administrative burden
Using your electronic health record, making it easier than ever to submit electronic prior authorizations (ePAs) integrated in your EHR. Save time for you and your staff and eliminate faxes.

Online ePA portals

Even if you don’t have ePA enabled in your Electronic Health Record (EHR) yet, you can use a secure online portal. It’s faster to send and receive responses, and it works for any prescription drug or pharmacy.
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Connect to all PBMs and payers with ePA from Surescripts.® It’s easy to submit ePA requests and you can save valuable time if you haven’t fully integrated ePA into your electronic health record workflow.
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CoverMyMeds® is a one-stop solution that works for all medications and all payers.
The ExpressPAth® portal lets you manage prescription drug ePAs for patients with Express Scripts pharmacy benefits, or if your patient’s health plan is part of Care Continuum. Not available for TRICARE® beneficiaries.

Other PA options

If you’re unable to use ePA, there are other ways to submit your PA request.

Call us at 800.753.2851, download a state specific fax form or fax your requests to the number shown on our general request form. For example, use the prior authorization general request form below if you would like to request a coverage determination (such as a step therapy exception) or if you would like to make an appeal for us to reconsider a coverage decision.

Other important resources

National Preferred Formulary (NPF)
Our highly-effective, clinically-based NPF is an example of how we make the market work for payers and patients by leveraging competition and directing members to medications with the lowest net cost. The NPF provides access to nearly 4,000 medications, including 600 brand-name drugs and 99% of all generics.
Medicare Part D Formularies
Express Scripts Medicare Part D formularies are reviewed by a Pharmacy & Therapeutics Committee comprised of independent, actively practicing physicians and pharmacists approved by the Centers for Medicare & Medicaid Services. Be sure to refer to the formulary that applies to your patient’s plan option.
TRICARE Home Delivery Pharmacy Program
We’re honored to enable military members and their families to get their medications delivered directly to their home or anywhere they choose. Home Delivery is more cost effective compared to filling prescriptions through retail pharmacies. Also, during the e-prescribing process, patient-specific TRICARE pharmacy data is now available to providers who have Real-Time Prescription Benefit functionality embedded in their electronic health record.
Drug Recalls
Visit the link below for a list of drug recalls managed by the U.S. Food & Drug Administration.
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ePrescribing NCPDP ID

For patients with an Express Scripts ID card or TRICARE beneficiaries, ePrescribe to:

Express Scripts Home Delivery NCPDP ID 2623735 4600 North Hanley Road St. Louis, MO 63134

For Workers' Compensation, ePrescribe to:

Workers’ Comp Express Scripts NCPDP ID 0320301 4600 North Hanley Road St. Louis MO 63134

 

ePrescribing questions? Call 800.211.1456 or email ePrescribing@express-scripts.com.

We're here to help
Need more information about these solutions? Call our Prescriber Assistance line: 888.327.9791. We’ll help in any way we can – 24/7/365.