If a member is requesting a coverage determination or an exception, please fill
out the appropriate form below and fax your request to either Express Scripts at
877-837-5922 or Curascript at 888-773-7386.
A decision about whether SCAN will cover a Part D prescription drug can be a
“standard” coverage determination (prior authorization) that is made within the
standard timeframe typically within 72 hours. Turn around times for non-formulary
exceptions and tier exceptions are typically within 72 hours upon
receipt of completed information. If incomplete information is given, then the
turnaround time will be delayed up to 14 days. Once a decision has been made,
Express Scripts will send a letter to the physician’s office and the member
regarding the decision of the coverage determination.
To check the status of a coverage determination and exception request, please
call Express Scripts at 800-417-8164 or Curascript at 888-773-7376.
To view all of the Prior Authorization Criteria please
click here
Physician Coverage Determination Link