Prior Authorization Requests

Choose the submission method that works for your practice

VerusRx offers three ways to submit a prior authorization request.
Electronic prior authorization is the fastest option and provides real-time status updates, so we recommend it whenever possible.

Electronic PA
Online Webform
Fax

1. Electronic Prior Authorization (ePA)

VerusRx has partnered with Surescripts® to offer ePA.

Already have Surescripts electronic prior authorization built into your EHR? There is no need to register for anything. Go directly to your EHR and submit your request from there.
If your EHR does not support ePA, you can use the Surescripts Prior Authorization Portal instead. There is no EHR requirement, no technology integration, and no cost to your practice. Signing up takes only a few minutes.
The portal offers enhanced security using CLEAR identity proofing through biometric technology and multi-factor authentication upon login.
Prior Authorization Portal:
Multi-factor authentication:

Please note: Submissions through CoverMyMeds® cannot be accepted. You must use Surescripts for ePA or one of the alternative options below.

2. Online PA Webform

Submit your request online in minutes at  https://paforms.com/verusrx/

No login is required. After clicking the link above, select “Online Prior Authorization Form,” select the appropriate drug class or “Other” if the drug is not listed, complete all required fields, attach supporting documentation, then click Submit Request. You can download a PDF copy of the completed form for your records.

Open Online PA Form

Fax

Please send your request via fax.

Fax the completed form and supporting medical records to our Prior Authorization team:

Fax: 833-225-1973

Download Form