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Prior Authorization Resources

Spend less time on prior authorizations, more time on patients.

Benefits of Electronic Prior Authorizations

Did you know that more than half of the prior authorizations we receive each month are electronic?

Now is a great time for you to make the switch to electronic prior authorization (ePA). Here’s why:

  • Faster to send and get reviews
  • Easier to use for prescribers, nurses and office staff
  • Works for any prescription drug and any pharmacy
  • Keeps all your ePA documentation and requests in one place

Get started today with one of these online portals.

EviCore® by Evernorth

The EviCore® by Evernorth portal lets you manage prescription drug ePAs for patients with Express Scripts pharmacy benefits. This also gives the convenience of managing your medical prior authorization needs with EviCore®.

Go to EviCore by Evernorth

Surescripts®

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.

Go to Surescripts

CoverMyMeds®

CoverMyMeds® is a one-stop solution that works for all medications and all payers.

Go to CoverMyMeds

Other Prior Authorization Resources

If you’re unable to use electronic prior authorization, 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.

Prior Authorization and Step Therapy Exception Resources

Please call us at 800.753.2851 to submit a verbal prior authorization request if you are unable to use Electronic Prior Authorization. Prior Authorization criteria is available upon request.

If you can't submit a request via telephone, please use our general request form or one of the state specific forms below and fax it to the number on the form. For example, use the 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.

For physicians requesting a Prior Authorization for patients with insurance through Blue Cross Blue Shield of Louisiana, please call 800.842.2015 or submit your request via fax using this form.

Prior Authorization Statistics

In an effort to promote transparency of its prior authorization programs, Express Scripts publishes the following approval and denial statistics.

Additional 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.
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.

Drug Recalls
Visit the link below for a list of drug recalls managed by the U.S. Food & Drug Administration.