Five Tips for Faxing Pharmacy Prior Auth Requests

Tip Sheet Clarifies Pharmacy Prior Auth Requirements

One of Highmark’s primary concerns is our members’ safe, effective, and timely receipt of prescription drugs that provide required treatment and pain management.

We understand there may be valid reasons why patients require medications that deviate from Highmark’s programs, policies, and contractual parameters. In these cases, prior authorizations are required. Highmark wants to work with you to ensure that prior authorizations are completed accurately and processed in a timely manner.

To assist you in expediting prior authorizations, Highmark has created a tip sheet titled Five Tips for Faxing Pharmacy Prior Auth Requests . This printable poster offers directions for submission of these critical prior authorizations that will drive consistency and improve approval timeframes.

Following are five keys to successfully completing a pharmacy prior authorization:

1. Include only one patient per prior authorization request. Limiting each fax to a single patient eliminates the risk of improper PHI disclosure.
2. Include only one prescription per prior authorization request. Limiting your request to one prescription reduces errors.
3. Include all required/supporting clinical information per request. Doing so ensures reviewers receive required information.
4. Prior to faxing, confirm all information is entered and completed accurately.
5. Finally, fax the prior authorization to 1-866-240-8123.

We hope you find this tip sheet, which is suitable for printing and hanging by your fax machine, to be valuable in expediting your authorizations.

In addition to accessing the tip sheet from the above link, you can easily locate the tip sheet on the Provider Resource Center by selecting Pharmacy Program/Formularies > Pharmacy Information. The tip sheet is located on the Pharmacy Information web page.