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 OR PRICING APPEAL INFORMATION
To initiate a MAC or pricing appeal, please click here.
TN Claims: The initial appeal process is availble for all prescription drugs
or devices for which a pharmacy alleges it did not receive its actual cost.
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Contact Us
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M-F: 7am - 9pm CST
Sat-Sun: 9am - 5pm CST