The following prescription drug forms are available as PDF files. Just click on a form to download it. Have your doctor fax in completed forms at 1-877-243- ...

Intended Use: Use this form to request authorization by fax or mail when an issuer requires prior authorization of a prescription drug, a prescription device, ...

BlueCross BlueShield of Texas has partnered with CoverMyMeds to offer electronic prior authorization (ePA) services. Select the appropriate BlueCross ...

Intended Use: Use this form to request authorization by fax or mail when an issuer requires prior authorization of a prescription drug, a prescription device, ...

Prior Authorization ; Provider Refund, Fillable ; Room Rate Update Notification, Fillable ; Urine Drug Testing Form for Out-of-Network Providers, Interactive.

To obtain the correct form, select the appropriate drug below and follow the instructions at the top of the form. You can search this page by using the search ...

Download and print the most commonly requested prior authorization fax forms for procedures, physician administered drugs and pharmacy outpatient drugs.

The Texas Standard Prior Authorization Request Form for Health Care Services is available on the BCBSTX website in the General Forms section. The above ...

Completing and faxing the Prior Authorization form. Checking our pre-approval drug list to learn more about our requirements and policy and to generate a ...

Please fill out the Prescription Drug Prior Authorization Or Step Therapy Exception Request Form and fax it to (844) 474-3347. Select the Drug List Search tab ...