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 Prime Therapeutics. 

Find answers to questions about the Drug Wastage Program’s expansion through Prime Therapeutics.

• Drug Wastage Program Frequently Asked Questions/Answers

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

• Frequently Asked Questions/Answers

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