How do I submit prior authorizations?
To submit a prior authorization (if required) please complete the prior authorization request form and fax it (along with any additional documentation required) to (833) 434-0563. Prior authorization request forms can also be sent via mail to the below address:
Download Prior Authorization Request Form
Capital Rx
Attention: Prior Authorization Department
9450 SW Gemini Dr., #87234
Beaverton, OR 97008
For additional prior authorization questions, please call 888-83CAPRX (888) 832-2779.
How long does a prior authorization review take?
Most prior authorization reviews are completed within two business days provided that a complete prior authorization request form and all required documentation are correctly submitted. Our clinical team will notify you in advance of any declinations and assist in expediting your patient to a preferred alternative therapy.
How do I submit mail order prescriptions?
To enroll in mail order, please have the member log in to our member portal. For additional mail order questions, please call (888) 832-2779.
How do I submit specialty drug prescriptions?
For specialty pharmacy questions, please have the member log in to our member portal by clicking on the member portal. For additional specialty questions, please call (888) 832-2779.
How do I request copies of utilization management criteria relevant to a prior authorization claim?
You may request copies of all documents associated with a claim, including the internal guideline or protocol relied upon in making the determination. This information is provided free of charge. Please contact Capital Rx at:
Capital Rx
Attention: Appeals Department
9450 SW Gemini Dr., #87234
Beaverton, OR 97008
Phone: (888) 832-2779
Fax: (833) 434-0563
How do I request an appeal if the medication I would like to prescribe is denied?
Please call us at (888) 832-2779 to determine if your patient’s prescription benefit plan allows for exceptions and/or appeals.
We're here to help answer your questions about member eligibility and prior authorization.
Give your clients the flexibility and power to reduce their drug spend with Capital Rx.
