As part of our utilization management (UM), retail pharmacy prior authorizations are delegated to Prime Therapeutics.
Retail Pharmacy Authorizations
- Retail pharmacy prior authorizations must be submitted to Prime Therapeutics. There are two ways to submit an authorization request:
- The preferred method is submission through CoverMyMeds, a website that allows providers, pharmacists and their staff to securely submit preauthorization/precertification requests electronically. If you aren't already using CoverMyMeds, we encourage you to sign up.
- If you do not use CoverMyMeds, you can download a form from the Prime Therapeutics website using one of the links below, complete it and fax it to Prime Therapeutics at 877-480-8130.
Retail Pharmacy Medical Policy
- BCBSND also partners with Prime Therapeutics to validate and approve retail pharmacy medical policies. These policies will be available on the Prime Therapeutics website.