Our call center is open 8am – 5pm with local and highly trained staff. We take great pride in the efficiency and effectiveness of our call center at meeting the needs of our plans, providers and pharmacies.
Prior authorization determinations (pharmacy and medical benefit drugs)
Universal Prior Authorization form can be found <here>. Once the form is complete with appropriate clinical information (office notes, lab values, medication history, etc.), then it may be faxed to 501-526-4189. If the form is complete with all necessary information, determinations are typically given within 24 hours.
Appeals (pharmacy and medical benefit drugs)
If a prior authorization is denied, providers have the right to appeal the decision. They may submit additional clinical information and/or a letter of medical necessity faxed back to 501-526-4189. Appeals are reviewed by a MD and determination made within 5 business days.
If plans need assistance on providing external reviews, we can facilitate external reviews with pass through pricing.
Support center for pharmacies
If claims are not going through at the pharmacy, we encourage pharmacists to call us at 877-540-9036.
Support center for providers
If providers have questions about formulary options, prior authorization requirements, or status of prior authorization/appeals, we encourage them to call us at 877-540-9036.