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URL: https://www.rxbenefits.com/prior-authorization-form/
Submission: On July 13 via manual from US — Scanned from DE

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SOLUTIONS

 * Solutions Overview
 * Optimize 360
 * Optimize Direct
 * RxBenefits Protect
 * RxBenefits Preferred Financial Assistance Solutions
 * RxPharmacy Assurance
 * Diabetes Support Program

WHO WE SERVE

 * Benefit Advisors
 * Mid-Market Employers
 * Hospitals & Health Systems
 * Third-Party Administrators
 * Private Equity

CONTENT HUB

 * Hospital & Health Systems
 * School Districts & Municipalities
 * Transportation & Logistics
 * Carve Out
 * Clinical / Utilization Management
 * Pharmacy Trends
 * Benefit Plan Design
 * Contract Best Practices

COMPANY

 * About RxBenefits
 * Pharmacy Benefits Optimizer (PBO)
 * Leadership
 * Culture & Careers
 * News

MEMBERS

 * Contact Us
 * Prior Authorization Form
 * Member Resources
 * Employer Resources




PRIOR AUTHORIZATION FORM AND STATUS CHECK 

Download Prior Authorization Form

Check Status on your PA Request

HWMG Members Prior Authorization Form


PRIOR AUTHORIZATION STATUS FAQS

Who can use Prompt PA to check the prior authorization status?

 * Members
 * Providers
 * Pharmacies

What status details will be available on Prompt PA?

 * Approved
 * Denied
 * In progress

What information do you need to check the prior authorization status?

 * Member ID
   * This can be located on your Medical ID card (if you have a combined medical
     and pharmacy card), on your Pharmacy card, or by calling the member
     services Prior Authorization line at 888.608.8851. 
 * Prior Authorizations (EOC) ID: a unique number assigned to the PA request.
   * You can find this by calling the Prior Authorization line at
     888.608.8851 or
   * You may have received a letter regarding this particular prior
     authorization. If so, your EOC will be included on the letter.
 * First name , last name, and date of birth of the member