MedImpact (IEHP Medicare Line of Business's PBM) handles all Medicare pharmacy and provider prior authorization and pharmacy benefit related questions. Providers and pharmacies can call MedImpact Customer Contact Center at (800) 788-2949. Health care providers can submit prior authorizations via fax (858) 790-7100, or download forms at the MedImpact Website.
- Request for Redetermination of Medicare Prescription Drug Denial - English (PDF)
- Request for Redetermination of Medicare Prescription Drug Denial - Spanish (PDF)
- Coverage Determination Form - Retroactive prior authorization requests (PA requests dated before 1/1/2023) should be faxed to (909) 890-5766.
