Join the LucyRx Pharmacy Network
LucyRx is redefining pharmacy partnerships—building a transparent, high-performing network that puts people first. We’re actively expanding to improve access to affordable, high-quality prescription care in every community.
Ready to partner?
PHARMACY PROVIDER RESOURCES
Pharmacy providers are at the heart of our claims process. We’re here to make your job easier with the resources and support you need to process claims quickly, smoothly, and stress-free.
Pharmacy Provider Manual
Check out our manual for general terms, conditions, procedures, and policies.
Payor Sheet
Access payor sheets for the latest requirements to submit claims electronically.
Workers’ Compensation Payor Sheet
Access payor sheet for the latest requirements to submit claims electronically.
MAC Appeals
MAC appeals will be reviewed in accordance with LucyRx’s standard MAC appeal process.
Tennessee Wholesaler Submission
Click here for more information about Tennessee wholesale and manufacturer information collection and to download our form.
SPARC Program
See how our SPARC Program supports independent pharmacies —and helps communities stay healthy.
PHYSICIAN RESOURCES
Prior Authorization Request Form
For Members with Bin #028769 ONLY
Download PDF and Fax to 833.414.3435
Prior Authorization Request Form – Fertility
Download pdf and fax to 800.476.2691
Prior Authorization Request Form
For Members With ALL other bins
Complete the form online or Download PDF & Fax to 800.476.2691
Prior Authorization Appeal Form
Download this form to appeal a prior authorization denial.