New York
Provider Communications
Empire accepts prior authorization requests for prescription medications online
Aug 1, 2018 • Products & Programs / Pharmacy
Empire accepts electronic medication prior authorization requests for commercial health plans. This feature reduces processing time and helps determine coverage quicker. Some prescriptions are even approved in real time so that your patients can fill a prescription without delay.
Electronic prior authorization (ePA) offers many benefits:
- More efficient review process
- Ability to identify if a prior authorization is required
- Able to see consolidated view of ePA submissions in real time
- Faster turnaround times
- A renewal program that allows for improved continuity of care for members with maintenance medication
- Prior authorizations are preloaded for the provider before the expiration date.
Providers can submit ePA requests by logging in at covermymeds.com. Creating an account is FREE.
While ePA helps streamline the prior authorization process, providers can also initiate a new prior authorization request by fax or phone. Please note, the contact numbers for all Medicare plans will change effective September 1, 2018.
New fax number | New phone number |
844-521-6938 | 833-293-0661 |
If you have other questions, please contact the provider service number on the member ID card.
Featured In:
August 2018 Empire Provider Newsletter
Empire BlueCross BlueShield HealthPlus (Empire) will administer pharmacy benefits for enrolled members. IngenioRX* is the pharmacy benefits manager. Please refer to the Preferred Drug List (formulary) from Empire when prescribing for our members. This guide does not contain a complete list of drugs; rather, it lists
the preferred drugs within the most commonly prescribed therapeutic categories. Though most medications on the PDL are covered without prior authorization, a few agents will require you to contact our Pharmacy department for authorization. Medications not listed in the formulary are considered to be non-formulary and are subject to prior authorization. Medicaid preferred drug list (formulary)
Searchable formulary: Medicaid
Searchable formulary: Essential Plan
Searchable formulary: Child Health Plus (CHPlus)
Health and Recovery Plan (HARP) PDL
Prior authorization requests
Some drugs, drug combinations and drug doses require prior authorization (PA). To submit electronic prior authorization (ePA) requests online, use Availity*.
Prior authorization phone and fax numbers
While online submissions helps streamline the PA process, you may also initiate a new PA request by calling or faxing a completed Pharmacy Prior Authorization form to Empire. Please note, the following contact numbers for prior authorization requests and PA form information below.
Prior authorization phone
Hours: Monday to Friday 8:00 a.m. to 7:00 p.m.; Saturday 10:00 a.m. to 2:00 p.m.
Phone:
1-800-450-8753
Prior authorization for retail pharmacy
Fax:
1-844-490-4877
Prior authorization for medical injectables
Fax:
1-844-493-9206
Prior Authorization forms for pharmacy services can be found on the Forms page.
Related resources
* IngenioRX is an independent company providing pharmacy support services on behalf of Empire BlueCross BlueShield HealthPlus.
Provider tools & resources
- Log in to Availity
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Reimbursement Policies
- Provider Manuals, Policies & Guidelines
- Referrals
- Provider Training Academy
- Forms
- Pharmacy Information
- Provider News & Announcements
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We look forward to working with you to provide quality service for our members.
Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place.
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