Effective Dec. 4, 2017, Drug Prior Authorization Requests for Some Drugs Can Be Completed Online for Federal Employee Program® Patients

October 02, 2017 -

CareFirst network providers are required to submit drug prior authorization requests online via the Provider Portal (CareFirst Direct). Previously, your Federal Employee Program (FEP) patients were considered out-of-scope and the requirement did not apply.

What Is Changing?

Effective Dec. 4, 2017, prior authorization requests for your FEP patients for these drugs only (at this time) can be submitted online via CareFirst Direct, following the same process that you currently use to submit any electronic drug prior authorization request.

Prior authorization requests for your FEP patients for any other drug should continue to be requested via the current FEP prior authorization process. Remember, you should always confirm how a drug should be submitted by checking online at carefirst.com/preauth.

Please continue to submit all drug prior authorization requests online for your other CareFirst patients, just as you do today.p>

Why Is This Change Being Implemented?

Submitting drug prior authorization requests online for these drugs will save your office time and money. Learn more about the benefits of electronic prior authorization.

Questions?

For more information on submitting a prior authorization request online:

  • View our training video
  • Download the user guide
  • For questions regarding online drug prior authorization for FEP only, call CVS Caremark at 800-469-7556.
  • For questions regarding online drug prior authorization for other CareFirst patients, call CVS Caremark at 888-877-0518 (specialty drugs) or 855-582-2038 (non-specialty drugs).