Effective July 1, 2024, Blue Cross Complete will accept electronic prior authorization requests through PerformRx via CoverMyMeds and Surescripts. ePA can help eliminate the need for fax or phone submissions and offers a more streamlined prior authorization process. 

How it works: 

Options to create and submit ePA requests include: 

1.Electronic Health Record Submissions: Care teams can use their EHR system to process ePA requests before a prescription is sent to the pharmacy. 

• During the prescribing process, providers are alerted that a PA is required. 
• Providers will receive a question set electronically from PerformRx. 
• Complete the question set and submit to PerformRx for review. 
• A status notification will be sent. If approved, provider can notify the pharmacy that the prescription can be processed. 

Care teams can also submit ePA requests after the prescription has been processed and rejected at the pharmacy. 

• You’re notified by the pharmacy that the medication requires PA. 
• Take action within your EHR to initiate the PA request. 
• You’ll receive a question set electronically from PerformRx. 
• Complete the question set and submit to PerformRx for review. 
• Once the review is completed, you’ll receive a status notification. If approved,  you’ll notify the pharmacy that the prescription can be processed. 

2. CoverMyMeds and Surescripts Provider Portal Submissions: 

Care teams can access a secure provider portal through the CoverMyMeds or Surescripts. This can avoid the need to set up and use an EHR tool, however the ePA request submission remains the same through the provider portal. 

If you have additional questions, please contact your Blue Cross Complete provider account executive or Provider Inquiry at 1-888-312-5713.