Here’s additional information about Dart Container prior authorization

In the May 2019 Record, we let you know that Inetico began providing prior authorizations for Dart PPO enrollees. Here’s additional information about the process.

Dart Container requires prior authorization for all chemotherapy drugs and treatment. This includes those that don’t require approval by Blue Cross Blue Shield of Michigan.

You must obtain approval for any chemotherapy drugs or treatment from Inetico, a care coordination and care management provider working on behalf of Dart Container of Michigan LLC.

In addition, send the following requests to Inetico for approval:

• Any injection medication that exceeds $500 and doesn’t require prior authorization by Blue Cross
• Inpatient admission, outpatient surgery, MRI, MRA, CT, CTA, bone scans, epidural, PT, OT, speech, infusion, chemotherapy and radiation therapies, home health care, dialysis and durable medical equipment over $1,000

Inetico replaced the services of AIM Specialty Health and New Directions Behavioral Health for Dart PPO enrollees, group number 71750.

Services that require authorization by Inetico include:

Medical

• Inpatient precertification
• Preauthorization
• Disease management
• Care transition to home

Mental health

• Inpatient
• Residential
• Partial
• Intensive outpatient
• rTMS, or repetitive transcranial magnetic stimulation

Substance use disorder

• Acute detox
• Residential
• Partial outpatient
• Intensive outpatient

Specialty health programs (previously managed by AIM)

• High-tech imaging (MRI, CT, PET)
• Proton beam

Inetico will also manage prior authorizations for air ambulance services, except for those related to specified organ and bone marrow transplants.

If you require Inetico’s services, call 1-877-224-6700.

Blue Cross Blue Shield of Michigan handles prior authorizations for specified organ and bone marrow transplants and specialty drugs.

Specialty drugs are a designation of pharmaceuticals that are classified as high-cost, high complexity drugs that typically require special handling, distribution, administration or monitoring. Prior authorization is required for specialty drugs that are covered under a member’s medical benefit, not the pharmacy benefit.

For specialty drugs, call the Pharmacy Clinical Help Desk at 1-800-437-3803.

For transplants, call the Human Organ Transplant and Air Ambulance Program at 1-800-242-3504.