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Please fill out all applicable sections on both pages completely and legibly. For information about carelonrx prior authorization, prescription exceptions, and utilization management: Attach any additional documentation that is important for. Online services intermediary authorization form; Our electronic prior authorization (epa) process through covermymeds is the preferred method to submit pa and exception requests. This form is to be filled out by a member if there is a request to release the member’s health information to another person or company. Our electronic prior authorization (epa) process is the preferred method for submitting pharmacy prior authorization requests. Carelonrx pa request form (medicare version) electronic prior authorization (epa) through your electronic health record.
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