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Blue Cross Complete Medication Prior Authorization Request Confidential Information Submit the completed form o By fax to 1-855-811-9326 By mail to PerformRx for Blue Cross Complete 200 Stevens Drive CC236 Philadelphia PA 19113 Note Blue Cross Complete s prior authorization criteria for a brand-name DAW request Documentation of an adverse event or lack of efficacy with the generic formulation and completion of an FDA MedWatch form. Please forwar.

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When it says “plan” or “our plan,” it means BCN Advantage.) Please contact our Customer Service number at 1‑800‑450‑3680 for additional information. (TTY users should call 711).

At Blue Cross Blue Shield of Michigan and Blue Care Network, we've contracted with AllianceRx Walgreen Pharmacy to handle mail-order prescriptions for specialty drugs.

If you have questions regarding the completion of a transaction that is not covered within this User Guide, please call the Provider Enrollment Help Desk at 1-800-822-2761 or contact your BCBSM or BCN provider representative.

As we announced in January, Blue Cross® Blue Shield® of Michigan and Blue Care Network have decided to switch to OptumRx1 as our new pharmacy benefit manager, or PBM, when our contract with Express Scripts Inc. 2 expires Dec. 31, 2021, for commercial business and expires Dec. 31, 2022, for Medicare business.

Please call 1-800-242-3504 to obtain a preauthorization.

The network specialty pharmacy fills prescriptions for specialty drugs. These types of drugs may be injected, infused or taken by mouth. Usually, you can't get these drugs at a local retail pharmacy. They often need special storage and handling, and they need to be delivered quickly.

Top 15 specialty pharmacies by revenue CVS Specialty — $52.9 billion. Accredo / Freedom Fertility — $43.5 billion. Optum Specialty Pharmacy — $25.8 billion. AllianceRx / Walgreens stores — $19.2 billion. Humana Specialty Pharmacy — $4.9 billion. Acaria Health — $4.7 billion.

Your pharmacy benefits coverage will be with OptumRx.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232