Prime therapeutics fax number for prior authorization

1. Provider
2. Policies & Precertification
3. Pharmacy

The BCBSND pharmacy program incorporates our philosophies around a holistic view of health. It also provides tools to help us collectively consider the value of drug benefits, monitor drug safety and improve health outcomes for North Dakotans.

Retail pharmacy medical policy

We partner with Prime Therapeutics to validate and approve retail pharmacy medical policies which are available on their website.

Medications or drugs that are generally high cost and may have other considerations such as special administration, limited availability, unique delivery and dispensing, or unique and/or required patient support or monitoring.

Specialty Drug List - updated October 2022

Value Based Design (VBD) drug list

Over-the-counter medications

Non-prescription drugs covered by BCBSND when dispensed by a pharmacist upon receipt of a prescription order.

Over-the-Counter Medications List - updated November 2019

Excluded route of administration

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Prime Therapeutics’ Preferred Method for Prior Authorization Requests

Our electronic prior authorization (ePA) solution provides a safety net to ensure the right information needed for a determination gets to patients' health plans as fast as possible.

Improving efficiencies without sacrificing the essentials

• 70%1 of users reported time savings
• 35%2 faster determinations than phone or fax
• HIPAA compliant and available for all plans and all medications
• No cost to providers and their staff

How it works

Three Easy steps to completing requests electronically

1. Create a free account in minutes
2. Verify your NPI to receive all requests initiated at your patient’s pharmacies
3. Use your account to initiate, access and submit requests

Want to learn more? Join a webinar.

“

I have been using this service since last year and it simply gets better and better. It has significantly reduced the paperwork burden of my office and office staff as far as prior authorizations go.

CoverMyMeds Provider

Dedicated Support

No hold times.
No phone trees.

We know PA requests are complex. That's why we have a team of experts and a variety of help resources to make requests faster and easier.

LET’s GET STARTED

1 - CoverMyMeds Provider Survey, 2019

2 - Express Scripts data on file, 2019