EXC - PRV - EPA Outage - temp
Expand the appropriate service type category to locate our CareAdvance Provider navigation guide, WebEx and tip sheet.
Please click here to access FAQs Opens a PDF.
If you receive an error message stating "You have no associated provider sets", we can help you;
please email your Web Username and Individual or Group NPI to CAPAdministrator@excellus.com to update the system.
If you have any questions, please contact your Provider Relations Representative.
Page Title for page template
Search for Required Medical Services-Request Authorization Page Tab Content
Prescription Drugs Authorization Page Content
In order to help assure our members have access to safe, effective drug therapy and to protect against inappropriate use and waste, we require prior authorization and step therapy* on selected prescription medications.
Prior Authorization & Step Therapy Requirements
- Commercial 3-Tier Prior Authorization and Step Therapy Medication ListOpen a PDF
- Child Health Plus Prior Authorization and Step Therapy Medication ListOpen a PDF
- Medicaid Managed Care Prior Authorization and Step Therapy Medication ListOpen a PDF
- Specialty Rx Medication List (Self-Administered Drugs)Open a PDF
- Provider-Administered Medical Specialty Drugs Requiring Preauthorization - Commercial, Exchange and MedicareOpen a PDF
- Provider-Administered Medical Specialty Drugs Requiring Preauthorization - Medicaid, Safety Net, and Essential PlanOpen a PDF
Request Approval Online with Electronic Prior Auth (ePA)
You and your staff can request a coverage determination electronically, directly from your electronic medical record (EMR) or through CoverMyMeds ePA Portal.
- You can submit requests for PA prospectively
- You can renew Prior Authorizations 60 days prior to expiration
- ePA through CoverMyMeds is free
- Any authorized personnel can use ePA
Request Approval by Fax or Eform
Send Coverage Determination Request via Secure Eform