In order to meet these deadlines, all relevant clinical information must be provided at the time a drug therapy review is requested. If the request form is missing medical information needed for Prime Therapeutics, LLC (Prime) to make a clinically appropriate decision, attempts to contact you will be made. If Prime reaches out to attain any necessary information that may be missing, it’s imperative that you respond in a timely manner to provide this missing information. This is important, as cases will be denied if they lack essential and additional information within the indicated timeframes. Any information received after these deadlines expire will be considered an appeal and will be handled as such.

To avoid unnecessary review levels and delays in access to medications, we recommend taking the following steps:

• Utilize the ePA tool at covermymeds.com.
• If using fax forms, please select and complete the correct form. Please fill in all fields and provide all requested documentation.
• Whether using fax or the ePA tool, review your responses before submitting to ensure accuracy.
• Only use urgent requests when truly needed.
• Be aware of timeframes and deadlines for review, and respond when Prime reaches out for additional information.
• Take office closures and staff availability into account when submitting requests.

Obtaining prior authorization for drug therapy reviews

Did you know that we offer a fast and seamless electronic way to submit requests for drug therapy review? CoverMyMeds is the electronic prior authorization (ePA) tool offered through BCBSRI and Prime. CoverMyMeds offers electronic submissions of prior authorizations for any prescription drug. When you submit prior authorizations electronically, they are seamlessly integrated with your electronic health record system offering you ePA functionality right in your office. Some of the benefits include:

• Reduction of administrative waste
• Faster determinations
• Validated and accurate prior authorization requests

Obtaining prior authorization for drug therapy reviews

Did you know that we offer a fast and seamless electronic way to submit requests for drug therapy review? CoverMyMeds is the electronic prior authorization (ePA) tool offered through BCBSRI and Prime. CoverMyMeds offers electronic submissions of prior authorizations for any prescription drug. When you submit prior authorizations electronically, they are seamlessly integrated with your electronic health record system offering you ePA functionality right in your office. Some of the benefits include:

• Reduction of administrative waste
• Faster determinations
• Validated and accurate prior authorization requests

To create a CoverMyMeds account:

1. Go to www.covermymeds.com
2. Click on "Create a Free Account"
3. Log in with the email and password used to register your account

We encourage you to take advantage of the benefits ePA has to offer and make this your primary tool for requesting drug therapy reviews.

For questions regarding the status of an existing prior authorization, please call BCBSRI’s Physician & Provider Service Center at (401) 274-4848 or 1-800-230-9050.

To create a CoverMyMeds account:

1. Go to www.covermymeds.com
2. Click on "Create a Free Account"
3. Log in with the email and password used to register your account

We encourage you to take advantage of the benefits ePA has to offer and make this your primary tool for requesting drug therapy reviews.

For questions regarding the status of an existing prior authorization, please call BCBSRI’s Physician & Provider Service Center at (401) 274-4848 or 1-800-230-9050.