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.
Physician Innovation
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.
- Visit this page for state specific forms and PA statistics
- Download Prior Authorization General Request Form (e.g., use this to initiate step therapy exception)
- Medicare Plan Members Coverage Review Information
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.