Retail Pharmacy Prior Authorizations

Effective July 1, 2018, Blue Cross Blue Shield of North Dakota (BCBSND) delegated all retail pharmacy prior authorizations to Prime Therapeutics. Prime also does authorizations and reviews for BCBSND for medications subject to quantity limits and step therapy. Medical pharmacy prior authorizations will continue to be reviewed by BCBSND.

Retail pharmacy authorizations need to be submitted to Prime Therapeutics. This can be done by submitting a fax to Prime at 877-480-8130 or on the CoverMyMeds website.

If a prescription for a retail pharmacy prior-approval drug is submitted and no prior approval is currently in the system, the claim will reject at point-of-sale (POS).