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Pharmacy Formulary Exception Request

Prior Authorization

As a member of GHC-SCW, you may request coverage of a drug that requires prior authorization or is not on the formulary. Your request can be submitted through GHCMyChartSM or through your Primary Care Provider (PCP). 

GHC-SCW uses current clinical practice guidelines, best practice guidelines, peer reviewed publications and/or evidence-based research in the development of its Prior Authorization and Step-Therapy Criteria.  You can click h​ere for more information.

Submit Your Request Using GHCMyChart

Log into your GHCMyChartSM account. From the menu, choose "Meds & Orders” followed by “Drug Formulary.”  Select “Ask the Pharmacy” to send a message to GHC-SCW Pharmacy.

Please indicate the drug you are requesting, the medical reason for the medication and the name of your PCP. GHC-SCW Pharmacy Administration will contact your PCP for any medical information needed to consider your request.    ​

Submit Your Request Through Your Provider (Non-Oncology)

Your prescriber will need to complete a prior authorization request form by visiting, https://www.navitus.com/.  Your prescriber will need to select "Prescribers" and login using their NPI number and state of practice. When a drug-specific prior authorization form is not listed, the Formulary Exception Request form may be used. The completed form should be faxed to the GHC-SCW number on the form.

​Submit Your Request through Your Provider (Oncology, including those requests for non-oncology uses)

Your prescriber will need to complete an electronic prior authorization request by visiting, ih.magellanrx.com. The first time they access the site, they will use the link titled “New Access Request – Provider" and follow the prompts. Once access is granted, the prescriber may search for the requested medication and answer the associated questions. An oncology medication NOT found on this portal should be submitted in the same fashion as a non-oncology medication (see above).​

More Information

GHC-SCW Pharmacy Benefits
Phone (608) 828-4811
Mon. – Fri., 8 a.m. – 5 p.m

GHC-SCW Pharmacy Locations​​

As of part of GHC's Bounce Back Plan and in an ongoing effort to protect our patients and employees, GHC Pharmacies will continue offering FREE MAIL DELIVERY AND CURBSIDE PICKUP for prescriptions for patients.

We STRONGLY encourage you not to walk into our clinics or pharmacies unless you are there for an appointment. Please make every effort to use our Mail Service, or if your prescriptions cannot be mailed, we will offer Curbside Pickup.

For MAIL DELIVERY 

Call Sauk Trails Pharmacy at 608-831-1773.
To expedite service, call M-F 8AM to 6PM.
Please have payment information ready to give to Pharmacy Associate.

For CURBSIDE PICKUP

Hatchery Hill Pharmacy at 608-661-7220
Sauk Trails Pharmacy at 608-831-1773.
Capitol Pharmacy at 608-257-5178

To expedite curbside pickup:
• Please call 1-2 business days in advance for refill requests. Due to increased volume, requests may take longer than usual.
• Call pharmacy and set up payment before driving in.
• Look for designated Curbside Pickup parking stalls and call pharmacy to let us know you have arrived and what stall you are in.
• Stay in your car and a pharmacy associate will bring it to you.​

Capitol Clinic Pharmacy - open on weekends and most holidays 9 a.m.- 5 p.m.

​(608)-257-5178 
Monday – Friday: 8 a.m. – 7 p.m. 
Saturday & Sunday: 9 a.m. – 5 p.m.

Hatchery Hill Clinic Pharmacy - closed on weekends and holidays.

(608) 661-7242
Monday: 8 a.m. – 6 p.m.
Tuesday: 8 a.m. – 7 p.m.
Wednesday – Friday: 8 a.m. – 6 p.m.

Sauk Trails Clinic Pharmacy  - closed on weekends and most holidays.

(608) 257-4869
Monday: 8 a.m. – 7 p.m.
Tuesday – Friday: 8 a.m. – 6 p.m. ​