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21-550 New Fax Numbers to Request Prior Authorization for Medications

Health Net·CA·Prior Authorization
Effective date
Oct 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

CalViva Health has updated fax numbers for medication prior authorization requests effective October 1, 2021. Pharmacy PA requests must use fax 866-399-0929, while medical pharmacy PA requests must use fax 833-953-3436.

Action Required

Action needed
By October 1, 2021: Update all prior authorization request processes to use new fax numbers. Use 866-399-0929 for pharmacy PA requests (medications prescribed and dispensed by network pharmacy) and 833-953-3436 for medical pharmacy PA requests (medications administered by healthcare professionals in office/hospital/infusion centers). Update staff procedures, forms, and any automated systems that reference the old fax numbers.