RxAdvance is now a part of nirvanaHealth. Click here to learn more.

Downloadable Forms (Prescribers)

General Prior Authorization Forms
Commercial Plan Prior Authorization Form
Medicare Prior Authorization Form
Drug Specific Prior Authorization Forms
Eucrisa (crisaborole)
Long-Acting Opioid Analgesics
Short-Acting Opioid Analgesics
Peer-to-Peer Form
Appeal Request Form
Request for PHI FormClick here to download form


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RxAdvance is now nirvanaHealth.

Since 2013, the RxAdvance team has been dedicated to disrupting the healthcare industry, specifically in pharmacy benefit management. After 3 years of development, we went live with our first client in 2016 and delivered groundbreaking pharmacy benefit management services. Now that we have proven success year-after-year, we have decided to expand our impact beyond just the PBM industry—onto the payer industry. These two industries alone control the majority of the healthcare spend in the United States, including the $900+ billion of waste generated annually. With our expansion into a new portion of the industry, we have outgrown the RxAdvance name, since it does not accurately capture the scope of our healthcare reach and mission. We are excited to announce our new name and brand—nirvanaHealth. The RxAdvance name has served us well for many years and will continue to do so under nirvanaHealth.