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January 2013
Submit pharmacy prior authorization requests online
2 types of drug prior authorizations
This article outlines the online process available for prior authorizations of self-administered drugs covered under Blues pharmacy benefits. This differs from the prior authorizations described in "Additional practitioner-administered specialty drugs to require prior authorization", because those drugs are covered under Blues medical benefits. They are administered by a health care practitioner.
As part of our efforts to make the drug prior authorization process more efficient, we’re asking prescribers to use our Web-based system when prescribing drugs for commercial members. You can identify commercial members by one of the following Rx group codes on their ID cards: BCBSMAN or BCBSMRX1.
Follow these easy steps:
- Log in to web-DENIS through the Provider section of bcbsm.com.
- Click on Medication Prior Authorization.
- Enter the drug requested in Drug Search Form.
- Click on the drug name.
- Enter patient and physician information.
- Answer a few questions related to the drug selected.
- Click on Submit. (Once submitted, you will receive a tracking number for future reference).
Your request will be placed in the queue for review by a member of the clinical staff. You can go online and check the status of a request at any time.
Offices that don’t support online options can fax prior authorization requests to 1-866-601-4425 or call 1-800-437-3803.
Lists showing drugs included in our pharmacy programs can be found on our Web-based prior authorization system or at bcbsm.com/rxinfo, under Prior Authorization / Step Therapy and New Pharmacy Programs.
For more information on using our Web-based system, see the June 2012 Record.
Note: At this time, the online prior authorization system cannot be used when prescribing drugs for Federal Employee Program® members. Call the CVS Caremark Pharmacy Program at 1-800-624-5060 for information on how to handle drug prior authorization for FEP members.
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