BCBS AFFILIATEAZPBM: Prime Therapeutics
Blue Cross Blue Shield of Arizona Prior Authorization Guide
Submit prior authorization requests and appeal denials with BCBS Arizona. Phone numbers, fax numbers, appeal deadlines, step therapy override rights, and clinical documentation tips for AZ providers.
Prior Authorization Contacts
PA PHONE
1-800-446-8331
PA FAX
1-602-864-4127
TURNAROUND
5 business days standard (AZ law), 24h expedited
TIMELY FILING
180 days
APPEALS MAILING ADDRESS
BCBS Arizona, Attn: Member Appeals, PO Box 13466, Phoenix, AZ 85002
Common Denial Reasons
- ⚠ Arizona HB 2536 PA timeline concerns
- ⚠ Step therapy not completed
- ⚠ Missing genetic/biomarker testing
- ⚠ Specialty pharmacy routing required
Step Therapy Requirements & Override Rights
Arizona HB 2536 (2022) requires PA decisions within 5 business days standard, 24 hours urgent. The law also limits frequency of PA renewals for stable chronic conditions. BCBS AZ generally requires methotrexate + one other DMARD failure before biologic approval for RA.
Tips for BCBS Arizona Submissions
- 1. Cite Arizona HB 2536 for expedited timelines if delayed
- 2. Prime Therapeutics is the PBM â use CoverMyMeds
- 3. PA for stable chronic conditions cannot be re-required annually under AZ law
- 4. Submit via Availity provider portal
External Review Authority
If BCBS Arizona denies your final internal appeal, you have the right to request an external review through: Arizona Department of Insurance and Financial Institutions.
External review decisions are binding on the insurer.