Express Scripts prior authorization fax number (2026)

Express Scripts prints 1-877-251-5896 as the fax number for prior authorization requests on its General Request Form. The line reads "Fax completed form to 1-877-251-5896." Express Scripts tells prescribers to fax to the number on that form when they cannot use electronic prior authorization or the phone line. An urgent request goes by phone, to the urgent number printed at the top of the form.

Which Express Scripts number goes with which request?

Express Scripts says more than half of the prior authorizations it receives each month are electronic. Its Prior Authorization Resources page puts the portals first, then the phone line, and fax last for an office that cannot call. Its pharmacy page for prescribers adds ExpressPAth and says it lets prescribers avoid phone or fax submissions.

Express Scripts gives two examples of what the General Request Form is for: a coverage determination, such as a step therapy exception, and a request that it reconsider a coverage decision. Appeals for Medicare Part D patients and for Cigna plans follow the separate routes in the table.

Some patients follow a different route. The Prior Authorization Resources page lists state forms for 17 states: Arizona, Arkansas, California, Colorado, Illinois, Iowa, Kansas, Louisiana, Massachusetts, Michigan, Nebraska, New Hampshire, New York, Oklahoma, Oregon, Texas and Vermont. It lists a separate form and phone line for patients covered through Blue Cross and Blue Shield of Louisiana, and a Medicare coverage page of its own. A health plan that publishes its own drug prior authorization form, as Cigna does, names its own number on it.

Match the form to the patient's plan. Some state forms name a different company (the Illinois form lists Prime Therapeutics) and others, such as Louisiana's and Nebraska's, leave the recipient blank, so call 800.753.2851 before you fax a state form.

For Medicare Part D patients, Express Scripts' Medicare coverage page (read October 7, 2026) splits the routes. Initial clinical coverage reviews use fax 1-877-251-5896, clinical appeals use fax 1-877-852-4070, and both use phone 1-844-374-7377. Administrative coverage reviews and appeals, which decide whether a drug is covered and at what cost sharing, use fax 1-877-328-9660 and phone 1-800-413-1328.

What goes with the Express Scripts form?

The General Request Form asks for:

• The patient's name, ID number, date of birth and phone number
• The prescriber's name, DEA or NPI number (marked required), phone, fax and address
• The diagnosis and ICD code
• The drug and strength, with the quantity requested and the days' supply
• Other drugs or therapies tried and why each failed, plus anything else the prescriber thinks matters to the review
• The prescriber's signature and date, and an office contact

The form carries a prescriber signature line, so the prescriber signs even when a biller or a front-desk teammate prepares and sends it. It also warns that a patient's plan may require more than it lists. Express Scripts also says its prior authorization criteria are available on request, so ask for them when you call 800.753.2851 and see what a plan will want before you fax.

What goes on the cover sheet?

Four things: Express Scripts as the recipient, your practice's name with its phone and return fax, the date, and the page count. The patient's name, the drug and the diagnosis stay on the form behind it. A cover sheet is the first page a stranger sees after a misdial, and one patient to a fax means a single slip exposes one record.

Prior authorization is a payment activity under 45 CFR 164.501, which puts what you send inside the minimum necessary standard in 45 CFR 164.502(b). Write your office's own fax number in the form's prescriber fax field, the number your practice receives on.

How do I send the form from a HIPAA fax account?

The General Request Form carries a diagnosis and a drug, so the service that sends it falls under the business associate definition in 45 CFR 160.103; Fax Pigeon signs the BAA with your practice at signup, on every plan.

1. Save the completed form as a PDF and add the prescriber's e-signature.
2. Upload it to your account, or send it from your email.
3. Enter 1-877-251-5896 and compare it, digit by digit, with the form in front of you.
4. Send, then file the delivery certificate with the request. It records that the pages reached the number.
5. Replies by fax land in your shared inbox with an AI summary, and email notifications arrive per fax or daily.

Plans start at $4.99 a month billed annually for 200 pages, sent and received combined (plans and pricing).

What if the fax fails or Express Scripts changes the number?

If no delivery certificate arrives, resend once. Then call 800.753.2851 for a verbal request, or use one of the portals. For an urgent request, call the urgent number printed at the top of the form and skip the fax.

Numbers move, and a copy of a form saved in a shared drive can carry an old one. Download the General Request Form from the Prior Authorization Resources page each time and compare its number with the one above. The form itself points to www.express-scripts.com/pa for current forms. A misdial sends a patient's record to a stranger, a risk that Is online fax more secure than email? walks through.

The form also asks for your fax number, so the number on your side matters just as much. If your practice is changing fax providers, port the current number in rather than start over. Porting in is free on any paid plan, the number on the form does not change, and the current provider keeps it working until the transfer lands, in 5 to 15 business days for most.

* Fax number verified October 7, 2026, on Express Scripts' own Prior Authorization Form, General Request Form (https://www.evernorth.com/sites/default/files/2024-02/General%20Request%20For_not%20for%20WLP%20requests_2018%20%282%29.pdf). Confirm it on the current form before you send patient information. Fax Pigeon is not affiliated with Express Scripts.