Need to treat a Blue Cross Medicare Plus BlueSM PPO and BCN AdvantageSM HMO-POS or BCN Advantage patient with medical drugs at a provider office, an outpatient facility location or the patient’s home? You'll need to submit a prior authorization request and follow our medical policies to avoid a rejected claim. You can submit your request by logging in to the provider portal or using Novologix. If you don't have access to the provider portal, learn how to get an account. In the meantime, you can submit your prior authorization request by locating the appropriate form on this page and faxing it. Drugs that require prior authorizationMedical policies and prior authorization request formsView our medical policies to learn about our drug guidelines. Also, view our Blue Cross Medicare Plus Blue PPO and BCN Advantage medication prior authorization request forms to fax your request. Looking for a generic medication authorization request form? You can submit a global request form (PDF). If you have a Blue Cross Blue Shield of Michigan PPO plan, or a Blue Care Network HMO plan, you can fill out the form below for a standard or expedited review. You should fill out this form if you need a drug or contraceptive that's not included on your drug list. If you have questions or need help with the appeal process, call the Customer Service number listed on the back of your Blue Cross ID card. Medication Authorization Request Forms for Drugs Covered Under the Medical Benefit On this page you'll find information for:
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Bcbs of michigan prior authorization form for medication
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