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Provider-Administered Drug Review Program

Blue Cross and Blue Shield of Alabama requires precertification of provider-administered drugs managed under a medical policy. Currently, precertification for these provider-administered drugs is required when administered in a provider's office, outpatient facility or home health setting. If precertification is not obtained, coverage will not be provided under the plan for the provider-administered drug. The Provider-Administered Precertification Drug List contains the list of drugs subject to the Provider-Administered Drug Review Program.

Precertification for oncology and non-oncology drugs can be initiated by following a link that appears in ProviderAccess Eligibility and Benefits for eligible members. Precertification review for provider-administered drugs is performed by Magellan Rx Management Drug Review. 

Find answers to questions about the Drug Wastage Program’s expansion through Magellan Rx.

Online policies can be found at AlabamaBlue.com/Providers/Policies.

If you have questions, contact your Provider Networks Consultant at 1-866-904-4130.

 

Magellan Rx ManagementSM is an independent company providing medical review services on behalf of Blue Cross and Blue Shield of Alabama.