Prior authorization requests
Attention Providers: Following a denied claim, you can complete the Prior Authorization Initiation Form to notify us of your intent to initiate a prior authorization request. The EmpiRx Health Team will review the initiation form and respond with a drug-specific form to be completed and returned by the provider, along with any additional required information, such as chart notes. Please fax Prior Authorization Initiation Forms to 551-359-7177.
For questions regarding the Prior Authorization Initiation Form, status updates on submitted requests, or general inquiries about the process, providers can contact EmpiRx Health at 877-361-4338 (select option 2).
Contact us:
Address: 5950 Hazeltine National Drive Suite 300 Orlando, Fl 32822
Fax: 551-359-7177
Phone: 877-361-4338 (select option 2)
