Baylor Scott & White Health Plan (BSWHP) Individual and Small Group Plans
Pharmacy Benefit Drug CoveragePrior Authorization and Exception Criteria
To request prior authorization or an exception for a drug that will be obtained under the pharmacy benefit, submit the request to Capital Rx.
Capital Rx processes prior authorization & exception requests for prescription drugs on behalf of Baylor Scott & White Health Plan. Capital Rx delegates development and maintenance of formulary utilization management criteria program services to Prime Therapeutics LLC.