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Use BCBSNC-Provided Fax Forms for Rx Review to Avoid Delays

Release Date: October 12, 2012

At Blue Cross and Blue Shield of North Carolina (BCBSNC), we want to respond quickly to your requests for prior review when it’s required for certain prescription medications.  To help expedite our responses to these requests, we provide drug-specific fax forms online for your convenience on our Prior Review page.  These forms may include questions about a patient’s medical history and/or condition, as well as drug-specific dosage or quantity information that is necessary for us to complete a timely review. 

We recently learned that some physicians (or third parties on their behalf) are using a generic fax form obtained from other websites, such as and, when requesting prior review from BCBSNC of certain prescription drugs, instead of using the correct drug-specific fax forms available at on the Prior Review page.  The only time a general fax form is acceptable to submit to BCBSNC is if it’s indicated as the correct fax form to use for requesting prior review of a specific drug.

Please inform your office staff or third-party vendors who may handle the submission of prior review requests on your behalf that the continued use of these unauthorized forms results in a delay in the review process, as well as additional work for all involved.  Encourage your staff to bookmark the BCBSNC Prior Review page so that they can quickly access the appropriate fax forms to use when requesting prior review of certain prescription drugs.

If you have any questions, please contact the Provider Blue LineSMat 1.800.214.4844.