Pharmacy – How to Request Preauthorizations

Blue Cross and Blue Shield of Nebraska’s Pharmacy department, in collaboration with our pharmacy benefit manager, Prime Therapeutics, LLC., develops programs and resources to inform both physicians and their patients, our members, about the appropriate, cost-effective use of pharmaceuticals. Given the rising cost of health care, some groups have chosen to implement programs that promote appropriate therapy through pharmacy preauthorization programs.  

BCBSNE is making it easier for providers to manage medication preauthorizations (PAs) with improved experiences available through CoverMyMeds. Key benefits include:

• Real-time eligibility checks to confirm coverage before submitting
  
• Electronic PA submissions - no more faxing paper forms
  
• Immediate confirmation of receipt - no need to call or resubmit
  
• Faster processing and reduced administrative burden
  

How to Submit?

• Participating providers: Use CoverMyMeds via NaviNet, our provider portal. Out-of-network or providers outside Nebraska: If you do not have access to CoverMyMeds via NaviNet, you may access CoverMyMeds through the Providers Preauthorization page.