Updated July 27, 2023
A MedImpact prior authorization form is used when the client in question is seeking a non-conventional prescription or one which is not on the preferred drug list. By filling out and delivering a prior authorization form, the physician is able to request coverage. For your convenience, the prior authorization form for MedImpact has been provided below.
- Fax: 1 (800) 788-2949
- Phone: 1 (858) 790-7100