EmpiRx Health puts the pharmacist at the center of the pharmacy care service model. This ensures the most clinically appropriate, cost-efficient medication therapies to optimize member care and reduce costs. EmpiRx Health’s Clinical Pharmacist recommended clinically appropriate medication not covered by former PBM.

What is Prior Authorization? Prescriptions for certain high-cost or sensitive drugs require a clinical review and prior authorization before they can be filled. As part of this process, EmpiRx Health reaches out to your doctor to gather information confirming …

pharmacy, or Limited Distribution Drug pharmacy partner, which may trigger a clinically-driven prior authorization. During this robust process, we consult with the member’s physician to make sure they are receiving the most clinically appropriate and cost-effective treatment for their health condition. After prior authorization, our Patient Saver

You can use your EmpiRx Health ID card at over 68,0 00 pharmacies nationwide including all pharmacy chains. You can find a network pharmacy by logging onto www.empirxhealth.com or calling 877-262-7435. What is a prior authorization and why is it necessary? Certain medications require prior authorization (PA) because of their potential side

Oct 7, 2024 · • Mail: Mail your 90-day prescription and completed Patient Profile and Medication Order Form with payment to PO Box 12607, Beaumont, TX 77726. • Please note that EmpiRx Health does not automatically refill your prescriptions.

To submit a prescription yourself, complete the enclosed mail service order form and mail it, along with the original prescription, to Benecard Central Fill in the preaddressed envelope provided. Refill orders can be submitted online, by phone, or by mail.

Member Portal - View claims history and prescription drug information. Prescription Benefit Booklet (PDF, 331KB) Formulary (PDF, 2MB) (July 2023) - Lists drugs considered generic, brand, and non-formulary.

pharmacy prior authorization request, call us at 844-462-0022. The pharmacy may dispense up to a 72-hour supply while awaiting the outcome of this request. Please contact the member’s pharmacy. 4. Access our website to view the Preferred Drug List. 5. An ICD/diagnosis code is required for all requests. An HCPCS billing code is required for ...

Required clinical information - Please provide all relevant clinical information to support a prior authorization review. Please provide symptoms, lab results with dates and/or justification for initial or ongoing therapy or increased dose and if patient has any

UMR’s Prior Authorization Requirement Search and Submission Tool is now available for most UMR-administered group health care plans through the secure provider portal on umr.com. The tool allows providers to easily look up services for a specific member and determine if prior authorization is required or pre-determination recommended.