Envolve Pharmacy Solutions is leading the way into the future of prescribing by providing the kind of full-service drug management that has a patient-focused philosophy, an attitude of partnership with prescribers, and the expertise, operations and data-driven technology to deliver better service and healthcare outcomes.
- We bridge the gap between medical and pharmacy to provide prescribers with a complete picture of the patient.
- Leading-edge analytics allow us to locate cost-effective prescriptions for patients that are clinically appropriate while helping to curb drug costs.
- Our innovative clinical programs support patient adherence to their medication regimen so they can achieve their best health.
On this web page, prescribers will find information about the pharmacy benefit for Envolve Pharmacy Solutions members as well as information regarding Prior Authorizations (PA).
If you do not see what you are looking for here, please contact our Member Services Center at:
Toll Free: (800) 460-8988
TTY: (866) 492-9674
Prior Authorization Submissions:
Submit your prior authorization (PA) requests electronically through our preferred solution CoverMyMeds.
Electronic prior authorization (ePA) automates the PA process making it a quick and simple way to complete PA requests. The ePA process is HIPAA compliant and enables faster determinations. For select drugs and plans, CoverMyMeds may issue immediate approval of your request and update your patient PA record to allow immediate claim adjudication.
Depending on the type of medication and whether any additional information is needed to process the PA request, the review process can take one day, a few days, or longer. Your assigned Envolve Pharmacy Services PA contact will guide you through the process if additional information is required. Please contact the Member Services Center at the number listed on this web page if you have questions about the PA review.
Requesting an Appeal:
If a PA request is denied, instructions for the Appeals process will be included within the communication sent informing you of the decision. Additional contact information will also be provided within the communication. Please contact the Member Services Center at the number listed on this web page if you have questions about an appeal.