Physician Forms

To take advantage of electronic prior authorization (ePA), please submit your prior authorization request to Express Scripts through your choice of online portals, Express Scripts' own ExpressPAth, Surescripts' CompletEPA QuickStart or CoverMyMeds.

If you are unable to use our website, please call us at 800.753.2851 to submit a verbal prior authorization request, or you may submit faxed prior authorizations to 877.328.9799.

State Specific Prior Authorization Information

Arkansas, Illinois, Michigan, Oregon, and Vermont physicians can use this Prior Authorization form: Download now.

To view a list of drugs with a Prior Authorization requirement, click here.

State Specific Forms are available here:

Express Scripts Medicare Prescription Plan Resources

EPA is a streamlined process that decreases turnaround time for Prior Authorizations (PAs), minimizes gaps in patient care, and can be used for Medicaid, Medicare, and Commercially insured members.

Please submit your prior authorization request to Express Scripts through your choice of online portals, Express Scripts' own ExpressPAth, Surescripts' CompletEPA QuickStart or CoverMyMeds.

For more information on Medicare Part D click here.

For additional Medicare Plan Member resources, click here.

BCBS of Louisiana

Call 800.842.2015 or Download form.