Thank you for accessing our prior authorization form.
If you have any trouble accessing the form or have questions about the authorization process, please reach out to the
Member Services Team at 800.334.8134 or customercare@rxbenefits.com.
If you have any trouble accessing the form or have questions about the authorization process, please reach out to the
Member Services Team at 800.334.8134 or customercare@rxbenefits.com.