WebObtaining Authorizations. Behavioral Health: 877-650-6112. Gastric Surgery/Therapy/Durable Medical Equipment/Outpatient Procedures: 888-236-6321. Home Health/Home Infusion Therapy/Hospice: 888-567-5703. Inpatient Clinical: 800-416-9195. Medical Injectable Drugs: 833-581-1861. Musculoskeletal ... WebHighmark transitions to MCG health clinical guidelines. Effective February 13, 2024, Highmark will incorporate MCG Health clinical guidelines into Highmark’s criteria of clinical decision support, replacing Change Healthcare (InterQual). This change is being made to align the clinical review processes and platforms for Highmark health plans.
2024 Highmark Blue Cross Blue Shield Senior Blue Select (HMO) …
WebApr 1, 2024 · As a reminder, third-party prior authorizations for Highmark Health Options include CoverMyMeds, Davis Vision, eviCore, and United Concordia Dental. Have questions? We can help. Review the Prior Authorizations section of the Provider Manual. Call Provider Services at 1-855-401-8251 from 8 a.m. – 5 p.m., Monday through Friday. WebSubmit prior authorization requests by fax using the forms listed below: Commercial prior authorization forms Select formulary General fax form Acute migraine agents CNS stimulants — high cumulative dose Immune modulating therapy Opioid management — Buprenorphine/naloxone (Bunavail ® /Suboxone ® /Zubsolv ®) and Buprenorphine … helmutfx api
Medical Policy and Pre-certification/Pre-authorization Information …
WebSep 30, 2016 · The Prior Authorization component of Highmark's Radiology Management Program will require all physicians and clinical practitioners to obtain authorization when ordering selected outpatient, non-emergency, diagnostic imaging procedures for certain Highmark patients (This authorization requirement doesn't apply to emergency room or … WebUse the Precertification tool within Availity OR Call Provider Services at: 1-866-231-0847 To request authorizations: From the Availity home page, select Patient Registration from the top navigation. Select Auth/Referral Inquiry or Authorizations. We look forward to working with you to provide quality service for our members. Join Our Network WebCheck our Preferred Drug List Services billed with the following revenue codes always require precertification: 0632 Pharmacy multiple sources Nonparticipating providers All services you render require precertification. Fax: 1-800-964-3627 Call: 1-866-231-0847 Related information Precertification lookup tool Precertification lookup tool helmut willke