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CoverMyMeds Streamlines Electronic Rx Prior Review Requests

Effective immediately, providers can use CoverMyMeds* to quickly submit prescription prior review requests electronically to Blue Cross and Blue Shield of North Carolina (BCBSNC) on behalf of your commercial BCBSNC patients who have their pharmacy benefits through Prime Therapeutics**. Using CoverMyMeds is completely up to you, but we think you’ll welcome the efficiencies and real-time responses you’ll gain with this e-solution—especially the time saved by not having to download and fax forms to BCBSNC and wait for a response.

 

 

 

Save Time With CoverMyMeds

Have your provider NPI handy, as it will be required on all BCBSNC pharmacy-related prior review fax forms as of the date noted above, regardless of whether you choose to use CoverMyMeds or continue faxing your requests to BCBSNC as you do today. In addition, you can:

 

  • Access the electronic prior review request forms at www.covermymeds.com by using "Blue Cross and Blue Shield of North Carolina" or "BCBSNC" as your form search terms
  • Check member eligibility via CoverMyMeds by doing the following: Enter ONLY the patient's name, date of birth and gender, then click on "Check Eligibility."  If the information returned and displayed matches the BCBSNC member's ID card, click on the box showing the identifying information.  This step is required in order to provide us with the information necessary to adequately identify your patient so that we can review your request.
  • Submit medical details electronically to BCBSNC that may be necessary for us to complete prior review for certain medications
  • Receive real-time responses regarding if a drug is approved or not in certain cases
  • Be alerted immediately by pharmacies using CoverMyMeds, if a claim denies at the pharmcy because it requires prior review

Schedule a Webinar or Demo for Your Staff

Learn more about CoverMyMeds by viewing brief training videos online, and create your free account today.  Share this informative flyer with your staff, especially those who work with your BCBSNC patients and their prescription needs. To schedule a CoverMyMeds Webinar and receive a demonstration of this free, convenient online tool, please contact Amber Harner with CoverMyMeds at aharner@covermymeds.com to find a time and date that will work for your office.

*CoverMyMeds® is an independent company not affiliated with BCBSNC. It is your responsibility to review and decide whether to use CoverMyMeds' services.  **CoverMyMeds can be used for pharmacy prior authorization requests for commercial BCBSNC patients, who use Prime as their pharmacy benefits manager. At this time, CoverMyMeds cannot be used for requests for State Health Plan, Federal Employee Program, or Blue Medicare patients, even if their plans use Prime.