WebMar 31, 2024 · Behavioral Health: 833-581-1866. Gastric Surgery: 833-619-5745. Durable Medical Equipment/Medical Injectable Drugs/Outpatient Procedures: 833-619-5745. Inpatient Clinical: 833-581-1868. Telephone: For inquiries that cannot be handled via NaviNet, call the appropriate Clinical Services number, which can be found here. WebNov 1, 2024 · Highmark Expanding our prior authorization requirements Effective November 1, 2024, Highmark is expanding our prior authorization requirements for outpatient …
Medical Policy and Pre-certification/Pre-authorization Information …
WebRadiology Management Program – Prior Authorization 4/1/2006 8 Prior Authorization Process Process Follow the steps listed below to complete a prior authorization. Step Action 1 The ordering physician’s office staff uses NaviNet® to request an authorization from NIA.* *Using NaviNet is the preferred way to request authorizations. WebFor a complete list of services requiring authorization, please access the Authorization Requirements page on the Highmark Provider Resource Center under Claims, Payment & … huh721212ale604_0f30146
Pre-Cert/Pre-Auth (In-Network) - CareFirst
WebThe requested drug will be covered with prior authorization when the following criteria are met: • The patient is 18 years of age or older AND o The patient has completed at least 3 … Webdrugs that require prior authorization. Please note that the drugs and therapeutic categories managed under our Prior Authorization and Managed Prescription Drug Coverage (MRXC) programs are subject to change based on the FDA approval of new drugs. For a complete list of services requiring authorization, please access the Authorization Requirements WebPrior Authorization For the following drugs and/or therapeutic categories, the diagnosis, applicable lab data, and involvement of specialists are required, plus additional information as specified: • Anti-rheumatic drugs (Enbrel, Humira, Kineret) • Forteo: at least two other osteoporotic therapies and risk for fractures (e.g., T-score) holiday inn pet friendly locations