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Blue Cross Blue Shield is a national federation of health insurance organizations, while Anthem operates as an independent member of that federation in certain states. Anthem offers unique plans and services that may differ from those of other Blue Cross Blue Shield members. Understanding these distinctions can help you choose the right plan, including how the PA estate form for Anthem Blue Cross can fit into your healthcare strategy.
Health insurance providers use Prior Authorization as a utilization management strategy which requires an evaluation of the medical necessity and cost-of-care implications of specific treatments, tests, and drugs given by medical care practitioners before administering them.
Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered by your benefits. This approval process is called prior authorization.
To be eligible for Anthem Blue Cross coverage for Wegovy, you may need to meet certain criteria. These criteria may include: Having a body mass index (BMI) of 30 or higher. Having a BMI of 27 or higher with at least one weight-related medical condition.
Is Anthem the Same as Blue Cross Blue Shield? No, BCBS is part of the Anthem family of brands, but the two entities each sell health insurance in different areas of the country.
Prior authorization?sometimes called precertification or prior approval?is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.