Pharmacy prior authorization
Request a pharmacy prior authorization (PA)
By phone
Call the pharmacy authorization services line at 1-800-562-3022 ext. 15483.
By fax
Download and complete the Pharmacy Information Authorization form (13-835A) and send to 1-833-991-0704.
Request a change in fee-for-service (FFS) reimbursement
Download and complete the Pharmacy Information Authorization form (13-835A). Fax request to 1-833-991-0704.
For questions, please email the pharmacy rates team.
Submit supporting documentation to an existing authorization
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If supporting documentation was requested by HCA on a drug or drug class specific form, fax the form as the first page followed by the supporting documentation; OR
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If HCA did not fax a specific form, fax a completed Pharmacy Information Authorization (HCA 13-835A) form as the first page followed by supporting documentation.
Need more information?
For information on billing and rates, the Apple Health preferred drug list, and expedited authorization codes, please visit the Prescription Drug Program on our provider billing guide and rates page.