All states › PBM appeal channels › Prime
Filing a MAC appeal with Prime Therapeutics
Email with an attachment, which means you keep a timestamped record without doing anything extra.
Prime is one of two PBMs documented as applying a successful MAC correction to all similarly situated pharmacies in the network, within 7 business days — prospectively, not retroactively.
- How you file
There is no MAC portal. Email the MAC appeals mailbox with the invoice attached, or fax 877-823-6373, or call 888-277-5510 and take option 1.
- Bulk filing
- In practice yes — attach what you need to one email.
- What they ask for
- Copy of the original invoice
- NPI
- NCPDP
- Member ID
- Rx number
- Fill date
- Generic drug name
- NDC
- Brief explanation
- Filing deadline
- 30 business days after the claim was submitted.
- Their turnaround
- Acknowledged in 3 business days, investigated within 7 business days unless state law sets another period. Held for continual review up to 90 days.
MACAppeals@primetherapeutics.com- Plan names that route here
- Prime Therapeutics
Before you file
The deadline that binds Prime is usually your state's, not theirs — and in most states the clock starts earlier than people assume. Work out your date, then check what your state requires them to disclose when they deny it.
What owners report about Prime
Add what happened to you
Response metadata only — how long they took and what came back. Never prices, never a MAC list. It takes about two minutes and it is the only way this becomes public.