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Forms & Documents
To submit a prior authorization request, please complete the Prescription Drug Prior Authorization Form and send it (along with additional documentation, if necessary) to any of the following:
- Fax: (833) 434-0563
- Electronic: CoverMyMeds® website
- Mail: Capital Rx
Attn: Claims Dept.
9450 SW Gemini Dr., #87234
Beaverton, OR 97008
For a complete list of network pharmacies available to you, click the "Download PDF" button below. For additional pharmacy network questions, please call (888) 832-2779.
If you are a provider and have questions about prior authorization exemptions or gold-card status related to Texas House Bill 3459 for requests submitted to Capital Rx, please review the available frequently asked questions. To update your preferred method of contact or contact information for gold-card status communications from Capital Rx, contact us at TXGoldCardSupport@cap-rx.com.
As a Capital Rx Prescriber, you have the right to file a complaint or appeal if you are dissatisfied with our services.
Our Customer Care Representatives will make all necessary efforts to resolve any concerns you may have at the time of the call. By calling the toll-free number located on the back of the member’s Prescription Benefit ID Card, Capital Rx’s Customer Care Department can help you with any type of dissatisfaction, including, but not limited to:
- Quality of your care concern.
- Lack of adequate service.
- Plan benefit concerns.
- Dissatisfaction with the prior authorization process or outcomes of a prior authorization request.
We are available to help 24 hours a day, 7 days a week, 365 days a year. If you prefer to file your complaint or appeal in writing, you may do so by mailing your written notice along with any supporting documentation to:
Capital Rx
Attn: Customer Care
9450 SW Gemini Dr., #87234
Beaverton, OR 97008
FAQ
Frequently asked questions
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 mail order 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.
