The Texas Prior Authorization Call Center administers pharmacy prior authorizations services for clients enrolled in Medicaid fee-for-service. Only the prescribing provider or a staff representative can request prior authorization.
The Provider Quick Reference (PDF) outlines the information that call center staff requires to quickly assist each caller. Requests with missing information will not be assessed until that information is provided. If the authorization request is approved then the person can return to their pharmacy to obtain the prescription. The claim will pay and no further action will be required. If the authorization request is denied then the prescribing physician's office will be notified.