PHYSICIANS

At FairosRx, we are here to help.

PRIOR AUTHORIZATIONS

Prior authorizations (PAs) can be submitted by completing the FairosRx Prior Authorization Request Form and faxing it to 866-816-2136. For assistance submitting a prior authorization or for questions, please contact FairosRx at 833-464-9600. We are available from 7:00am to 9:00pm CST Monday through Friday and Saturday and Sunday from 9:00am to 5:00pm CST.


MAIL ORDER

WellDyneRx is our mail order pharmacy partner. Prescriptions can be ePrescribed or faxed to 877-221-1259.


For assistance in submitting a mail order prescription to WellDyneRx, please call 833-464-9600.


SPECIALTY MEDICATIONS

Access the FairosRx Specialty and Limited Access Drug List here.


For assistance or questions about specialty medications, please call 833-464-9600.

PHARMACISTS

At FairosRx, we are here to help.

CLAIMS PROCESSING INFORMATION

To process a pharmacy claim, use the following information:


RxBIN: 021841


RxPCN: 18000405


If you need assistance processing a pharmacy claim, please contact our pharmacy help desk at 833-464-9600. We are available 24 hours a day, seven days a week.



MAC APPEAL INFORMATION

To initiate a MAC appeal, please click here.



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