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FORMS & MANUALS
HEALTHCARE INFORMATION & TECHNOLOGY
PATIENT HEALTH
PHARMACY
POLICIES & GUIDELINES
PRE-SERVICE REVIEW
PROGRAMS & INITIATIVES
PROVIDER NETWORKS & SPECIALTIES
Home Infusion
Home infusion includes services provided in a patient’s home by a home infusion agency or provided in an infusion suite associated with the home infusion agency. Services include intravenous or subcutaneous administration of drugs and total parenteral nutrition (TPN).
Refer to the Home Infusion manual for information about our policies, procedures, and a variety of topics important to home health providers.
Precertification of Home Infusion Services
Precertification for provider-administrated drugs may be required by the patient’s health plan. Be sure to verify benefits for each patient (including Blue Advantage®). Precertification can be initiated by following a link that appears in ProviderAccess Eligibility and Benefits for eligible members. This precertification review for provider-administered drugs is performed by Prime Therapeutics.
It is the responsibility of the ordering physician to obtain the precertification, and it is the responsibility of the home infusion agency to verify that it has been obtained. There are no retroactive certifications for most benefit plans.
Medical Policies – View medical policies by selecting Provider-Administered Drug Policies under Pharmacy Resources.
Webcasts:
Home Health and Home Infusion Updates
September 2021
Home Health and Home Infusion Updates Part 2
December 2021
Blue Advantage is a Medicare-approved PPO plan provided by Blue Cross and Blue Shield of Alabama, an independent licensee of the Blue Cross and Blue Shield Association.
Prime Therapeutics® LLC, is an independent company contracted by Blue Cross and Blue Shield of Alabama to provide pharmacy benefit management services.