|
January 2018
Update: Commercial Medical Drug Prior Authorization Program
The Commercial Medical Drug Prior Authorization Program encourages proper utilization of high-cost specialty medications administered by health care providers for many Blue Cross Blue Shield members. The list below includes all the specialty medications included in the program as of Jan. 1, 2018:
Keep in mind that prior authorization is a clinical review approval only, not a guarantee of payment. Blue Cross reserves the right to change the prior authorization list at any time.
We accept requests for prior authorization in three ways:
Fax |
Mail |
Phone |
1-877-325-5979 |
BCBSM Specialty Pharmacy Program
P.O. Box 2320
Detroit, MI 48231-2320 |
1-800-437-3803 |
You can find prior authorization forms for all physician-administered medications on web-DENIS. After you log in, follow these steps:
- Click on BCBSM Provider Publications and Resources.
- Click on Commercial Pharmacy Prior Authorization and Step Therapy forms.
- Click on Go to the Forms page.
- Click on Physician administered medications.
Our standard processing time to review requests is 15 days. We’ll review urgent requests within 72 hours.
Note: The prior authorization requirement doesn’t apply to Federal Employee Program® members.
| 
