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Email/form is not secure and is not for prescriptions, appointments or medical advice. Contact the individual clinic for patient portal assistance.

Public records-office contact; use the practice’s authorized records process and required release documents. The page says email is not secure.

Program-specific administration; not insurer claims or authorization. The page excludes prescription, appointment and medical-advice requests by email.

Send payments to the address printed on the patient’s statement. The corporate address is not a published payment lockbox. Email is not secure and is not for prescription, appointment or medical-advice requests.

CMS ACO ID A2107. Public reporting / administrative contact from the CMS PY2026 dataset, modified April 16, 2026. This is not a claims, eligibility, enrollment, or urgent clinical line. State tags identify states containing counties where more than 1% of assigned beneficiaries reside; they are not a statewide service-coverage or eligibility guarantee. The ACO reporting website was supplied in the dataset and was not individually reviewed in this batch.

CMS ACO ID A3280. Public reporting / administrative contact from the CMS PY2026 dataset, modified April 16, 2026. This is not a claims, eligibility, enrollment, or urgent clinical line. State tags identify states containing counties where more than 1% of assigned beneficiaries reside; they are not a statewide service-coverage or eligibility guarantee. The ACO reporting website was supplied in the dataset and was not individually reviewed in this batch.

Form revised April 1, 2025; directly designated by the current July 2026 provider PA page. Confirm the member’s plan and form. Separate plan-specific routes appear on that page.

Published fallback when the Prime Therapeutics Management provider portal does not answer the provider’s question. Page displays Updated 07/2026.

Current public contact page publishes 800-695-5526 for pharmacies/providers PA and technical support. The currently linked August 1, 2026 PDL front page also publishes PA phone 800-695-5526 and fax 844-347-3202; it is the newest PDL visibly listed by the provider PDL tab on October 22. The live provider homepage explicitly scopes this portal to Nevada Fee-For-Service Medicaid; no Medicaid managed-care acceptance is inferred. Current PA page directly links the General PA form, revision October 12, 2022, and says these forms are for pharmacy claims only; physician-administered drug PA uses gatewaypa.com. General PA excludes nonpreferred/drug-specific forms; use the applicable form. Government transition notice names Magellan effective July 1, 2022; current Prime branding is separate evidence, not an invented rename date.

Gateway PA portal and CoverMyMeds also used.

Alaska Medicaid general PA form (Prime Therapeutics Management LLC, Attn: GV-4201). Physician-office J-code Botox requests use a different route per Alaska forms.

Arkansas Medicaid oncology medication PA form fax (questions to the Arkansas Medicaid Pharmacy Program at 501-683-4120 per the form). Not for non-oncology PA requests.

Arkansas Medicaid Prescription Drug Program: fax PA forms from the Arkansas Medicaid Pharmacy Portal (responses within 1 business day) or submit ePA via CoverMyMeds; Prime Therapeutics Pharmacy Call Center for questions. Oncology PA forms use a different fax (800-424-5851).

Prime Therapeutics HCSC prior authorization/step therapy prescriber fax form lists the BCBSIL phone and the shared HCSC fax 877-243-6930. For pharmacy-benefit drugs for HCSC commercial members; not for medical-benefit drugs or Medicare Part D.

Prime Therapeutics HCSC prior authorization/step therapy prescriber fax form lists the BCBSMT phone and the shared HCSC fax 877-243-6930. For pharmacy-benefit drugs for HCSC commercial members; not for medical-benefit drugs or Medicare Part D.

Prime Therapeutics HCSC prior authorization/step therapy prescriber fax form lists the BCBSNM phone and the shared HCSC fax 877-243-6930. For pharmacy-benefit drugs for HCSC commercial members; not for medical-benefit drugs or Medicare Part D.

Prime Therapeutics HCSC prior authorization/step therapy prescriber fax form lists the BCBSOK phone and the shared HCSC fax 877-243-6930. For pharmacy-benefit drugs for HCSC commercial members; not for medical-benefit drugs or Medicare Part D.

Prime Therapeutics HCSC prior authorization/step therapy prescriber fax form lists the BCBSTX phone and the shared HCSC fax 877-243-6930. For pharmacy-benefit drugs for HCSC commercial members; not for medical-benefit drugs or Medicare Part D.

AHCA Florida Medicaid PA forms direct completed forms to Prime Therapeutics State Government Solutions LLC, Prior Authorization, P.O. Box 7082, Tallahassee, FL 32314-7082. Fee-for-service only; Statewide Medicaid Managed Care plan members use their plan PBM.

GatorCare (University of Florida employee health plan) PA/step therapy prescriber fax form, administered by Prime Therapeutics Management.

Colorado Medicaid prior authorization form (Prime Therapeutics, revision 09/27/2024) lists the PA help desk and PA fax. For Health First Colorado fee-for-service pharmacy-benefit drugs.

Prime Therapeutics Pharmacy Support Center provider line for Idaho Medicaid: PA status, claims processing, drug coverage/payment, eligibility, plan limitations, COB. New PA requests go to the Idaho Medicaid Pharmacy call center/fax.

Medi-Cal Rx (pharmacy benefit administered for DHCS with Prime Therapeutics). Fax is the PA and PA appeal fax; phone is the Medi-Cal Rx Customer Service Center (TTY 711) for questions — Medi-Cal Rx states PA requests cannot be submitted by phone (use the portal, CoverMyMeds, NCPDP P4, fax or mail). Use the Medi-Cal Rx PA Request Form.

MDHHS general prescription drug PA form; requests go to Prime Therapeutics State Government Solutions. Michigan Medicaid FFS pharmacy benefit; Medicaid health plan members use their plan PBM.

Prime Therapeutics Management prescription drug PA form for Unified Labor Rx (commercial client). ePA also accepted via CoverMyMeds per the form.

Specialty medication support. Medical-benefit PA inquiries use the number on the member ID card.

Includes DME and home-care service authorizations.

Pharmacy claim submission for PrimeWest Medicaid programs via its PBM MedImpact. Not for medical claims.

Part D pharmacy claim submission via MedImpact (same fax 1-858-549-1569 as Medicaid pharmacy claims). Not for medical claims.

Contact published in Maryland Department of Health’s Local Partners directory. The source does not state routine hours, fax, administrative email, or office address; those fields remain blank. Contact the department to identify the relevant program.

District headquarters listed as Prince William Health Department in the VDH January 2026 directory, PDF page 46. County tags describe the district administrative jurisdiction; office services and local clinic arrangements vary.

District headquarters listed as Prince William Health Department in the VDH January 2026 directory, PDF page 46. County tags describe the district administrative jurisdiction; office services and local clinic arrangements vary.

Publicly designated health officer contact from the NJ Department of Health directory, page 55. The separate emergency after-hours number is excluded. Individual agency websites were not independently reviewed.

Maine CDC official local-health-officer directory. Department contact number is reproduced without staff names or personal email addresses. State page provides no record update date, office address, fax or public mailbox. Read only; telephone reachability not tested.

Page lists email as one of four submission methods; use the privacy ID only, not SSN.

In the portal, locate the patient and claim, choose Provide info, then select the inquiry type and attach documents.

Use the member privacy ID. Principal says claims using a Social Security number are not accepted. Portal and clearinghouse submission are also listed.

Provider portal offers benefit breakdowns and claim information.

Clearinghouse option named on the page; not Principal itself. Vyne Dental is 800-782-5150.

Page: ECHO Health issues Optum/Principal payments; ERA payer ID 58379.

Page: non-Principal plan dental providers may email or fax to update information; other offices use the manage network membership forms.

Page: remove someone's portal access by phone; have name, address, phone and TIN ready.

Page: dentists practicing in Washington email to request an application.