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Blue Cross Blue Shield of Michigan uses the NovoLogix® tool to manage prior authorization requests for medical benefit drugs. Note: Prior authorization requests for medical oncology and supportive care drugs are managed by Carelon Medical Benefits Management.

services beyond those ordinarily covered by Medicaid or needs a service that requires prior authorization (PA). In order for Medicaid to reimburse the provider in this situation, MDHHS requires that the provider obtain authorization for these services before the service is rendered.

If your health care provider is in-network, they will start the prior authorization process. If you don't use a health care provider in your plan's network, then you are responsible for obtaining the prior authorization.

To qualify for Medicaid in Michigan, your household income must be at or below 133% of the federal poverty level. Today's income limits for Michigan Medicaid are roughly $18,000 for an individual, $24,000 for a couple, or $36,000 for a family of four.

Aetna partners with Novologix to offer free electronic prior authorization services for specialty drugs on Aetna's National Precertification List. You can use this service for commercial and Medicare members for all health plans.

For more information on obtaining clinical criteria or submitting a prior authorization request, refer to the Blue Cross Pharmacy Benefit Drugs page on the ereferrals.bcbsm.com website. Providers can obtain clinical criteria and forms by calling 1-800-437-3803.

Aetna has contracted with eviCore healthcare, an independent specialty medical benefits management company, to administer prior authorization for Enhanced Clinical Review program.

Yes, as long as the prior authorization request is directed toward an insurer subject to Section 2212e as an insurer that delivers, issues for delivery, renews, or administers a health benefit plan in Michigan.

We will make a decision within 5 business days, or 72 hours for urgent care. If we deny your service, we will explain why in the letter.

Your doctor must submit a request for a prior authorization for you. They must also submit an override of a drug restriction. Requests from pharmacists aren't accepted.

Blue Cross Blue Shield of Michigan uses the NovoLogix® tool to manage prior authorization requests for medical benefit drugs. Note: Prior authorization requests for medical oncology and supportive care drugs are managed by Carelon Medical Benefits Management.

services beyond those ordinarily covered by Medicaid or needs a service that requires prior authorization (PA). In order for Medicaid to reimburse the provider in this situation, MDHHS requires that the provider obtain authorization for these services before the service is rendered.

If your health care provider is in-network, they will start the prior authorization process. If you don't use a health care provider in your plan's network, then you are responsible for obtaining the prior authorization.

To qualify for Medicaid in Michigan, your household income must be at or below 133% of the federal poverty level. Today's income limits for Michigan Medicaid are roughly $18,000 for an individual, $24,000 for a couple, or $36,000 for a family of four.

Aetna partners with Novologix to offer free electronic prior authorization services for specialty drugs on Aetna's National Precertification List. You can use this service for commercial and Medicare members for all health plans.

For more information on obtaining clinical criteria or submitting a prior authorization request, refer to the Blue Cross Pharmacy Benefit Drugs page on the ereferrals.bcbsm.com website. Providers can obtain clinical criteria and forms by calling 1-800-437-3803.

Aetna has contracted with eviCore healthcare, an independent specialty medical benefits management company, to administer prior authorization for Enhanced Clinical Review program.

Yes, as long as the prior authorization request is directed toward an insurer subject to Section 2212e as an insurer that delivers, issues for delivery, renews, or administers a health benefit plan in Michigan.

We will make a decision within 5 business days, or 72 hours for urgent care. If we deny your service, we will explain why in the letter.

We will make a decision within 5 business days, or 72 hours for urgent care. If we deny your service, we will explain why in the letter.