800-437-3803

Clinical Help Desk at 1-800-437-3803 • For requests submitted to Carelon, calling the Carelon Contact Center at 1-844-377-1278 How will members be notified of approvals and denials? For both approvals and denials, Blue Cross, BCN or Carelon will send written notices to the member and the requesting provider..

Precertification: 800-572-3413 Mental Health/Substance Abuse Precertification: 800-762-2382 Rx Claims/Rx PriorAuth. 800-437-3803 bcbsm.com Blue Dental SM. BCN Customer Service 1-800-662-6667 (TTY users: 711) Or call the number on the back of your BCN member ID card. 8 a.m. to 5:30 p.m.Service Contact Information Behavioral health For Federal Employee Program members, call 1-800-342-5891 to refer for care. For MESSA members, call 1-800-336-0022 to refer for care. For all other members, call New Directions at 1-800-762-2382 to refer for care. Call PARS for all member-benefit-related questions: Professional providers, call 1 ...assistance- 800 437-3803. To request additional or replacement cards, employees can access their online account at www.bcbsm.com Additionally, the mobile app available through bcbsm.com will provide you with the availability of accessing a virtual ID card through your mobile device. This document is an outline of the coverage proposed by the ...

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Handy tips for filling out 800 437 3803 online. Printing and scanning is no longer the best way to manage documents. Go digital and save time with signNow, the best solution for electronic signatures.Use its powerful functionality with a simple-to-use intuitive interface to fill out 1 800 437 6020 online, e-sign them, and quickly share them without jumping tabs.TTY/TDD 800-257-9980 To locate participating providers outside of Michigan:2 800-810-2583 Misuse may result in prosecution. If you suspect fraud, call: 800-482-3787 Mental health/substance abuse treatment: 800-482-5982 Dental Servicing: 888-826-8152 Providers Only: Medical Authorizations: 800-392-2512 Rx Prior Authorizations: 800-437-3803 bcbsm ...Blue Cross Blue Shield /Blue Care Network of Michigan Medication Authorization Request Form. Required Demographic Information: Patient Weight:How to create an eSignature for the 1 800 437 3803. ... State of Michigan MIChild Customer Service at 1-800-543-7765. You can take your child to any dentist in our PPO network. To find one near you, visit our website at bcbsm.com. Benefit Information 01/01/2018 (if applicable) ...

Page 1 of 3 1 Request for Medicare Prescription Drug Coverage Determination Requests for coverage determination can also be made by phone at 1-800-437-3803 or at https://www.If you have any questions regarding this process, please contact BCBSM Provi der Relations and Servicing or the Medical Drug Helpdesk at 1 -800-437-3803 for assistance. PATIENT INFORMATION PHYSICIAN INFORMATION1-800-437-3803. Their hours are Monday through Friday from 9 a.m. to 4 p.m. Eastern time. Note: To determine which vendor manages authorizations for specific procedures and services, see the . Summary of utilization management programs for Michigan providers. Behavioral health codes (mental health and substance use disorders) Code listBlue Cross Blue Shield /Blue Care Network of Michigan Medication Authorization Request Form. Required Demographic Information: Patient Weight:

For questions about utilization management requirements, call the Blue Cross / BCN Pharmacy Clinical Help Desk at 1-800-437-3803. For questions about the CoverMyMeds web tool, call the CoverMyMeds support center at 1-866-452-5017. *Clicking this link means that you're leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website.Pharmacy Clinical Help Desk at 1-800-437-3803. PATIENT INFORMATION PHYSICIAN INFORMATION Name . Name ID number . Specialty Date of birth . Male Female Address Diagnosis : City/State/Z IP Drug name/HCPCS code . Phone: ( ) - Fax: ( ) - Dose and quantity . NPI Directions . Contact person Date of services : Contact person'sBCBSM ….

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Blue Cross Blue Shield /Blue Care Network of Michigan Medication Authorization Request Form. Required Demographic Information: Patient Weight:If you suspect fraud, call: 800-482-3787 24 Hr./7 Day Nurse Help Line: 800-775-2583 Dental Servicing: 888-826-8152 Benefits & Eligibility: 800-676-2583 VSP - Vision: 800-877-7195 Precertification: 800-572-3413 Mental Health/Substance Abuse Precertification: 800-762-2382 Rx Claims/Rx PriorAuth. 800-437-3803 bcbsm.com Express Scripts® Pharmacy ...

1-800-437-3803 for assistance. PATIENT INFORMATION PHYSI CIAN INFORMATION Name . Name ID Number : Specialty D.O.B. Pt weight (in kg) Male Female . Date recorded: _____ Address Diagnosis : City /State/Zip Drug Name . Phone/Fax: P ...If you have any questions regarding this process, please contact BCBSM Provider Relations and Servicing or the Medical Drug Helpdesk at 1 -800-437-3803 for assistance. PATIENT INFORMATION PHYSICIAN INFORMATIONBlue Cross Blue Shield/Blue Care Network of Michigan Medication Authorization Request Form. Required Demographic Information: Patient Weight: _____ kg

lone star help desk Chart notes are required for the processing of all requests. Please add any other supporting medical information necessary for our reviewDRAMS Clinical HelpDesk: 800-437-3803 Vendor Help# (technical assistance): 800-437-3803 Vendor Re-Certification Required: Yes Pharmacy Reg. with Payer Required: Pharmacies must register For DRAMS submission at one Of the following numbers: 313-486-2475 or 2028. Total Switch Contract with NDCHealth Req: Yes. ... west hartford hourly weatherpublix super market at driftwood plaza If you have any questions regarding this process, contact the Pharmacy Clinical Help Desk at 1-800-437 -3803. PATIENT INFORMATION: PHYSICIAN INFORMATION. Name : Name ID Number . Specialty D ate of birth : Male Female . Address Diagnosis (include ICD-10) City /State/Zip Drug Name Phone: ( ) - F. ax: ( ) - Dose and Quantity . NPI ... wells fargo lubbock tx Blue Cross Blue Shield /Blue Care Network of Michigan Medication Authorization Request Form. Required Demographic Information: Patient Weight:Title: Microsoft Word - Opioid day supply limits-Prov letter.docx Author: e121806 Created Date: 12/12/2017 6:48:28 PM weather radar appleton wioreillys brownsvillemyhealth cvs and submit via fax to 1877- -325-5979. If you have any questions regarding this process, please contact BCBSM Provider Relations and Servicing or the Medical Drug Helpdesk at 1-800-437-3803 for assistance.1-800-437-3803 to obtain PA and ST requirements and forms. Walgreens Specialty Pharmacy provides specialty drugs to BCN members in Michigan. All drugs shipped into Michigan billed by other specialty pharmacies require authorization. Durable medical equipment purchased in or shipped to Michigan pollen count springfield mo Blue Cross Blue Shield /Blue Care Network of Michigan Medication Authorization Request Form. Required Demographic Information: Patient Weight:: Has the patient received two or more lines systemic therapy that include anti-CD20 monoclonal antibody for CD20-positive tumor and anthracycline-containing chemotherapy regimen? 2815 grand concourseculver's paducah menumansfield isd classlink If you have any questions regarding this process, contact the Pharmacy Clinical Help Desk at 1-800-437-3803. PATIENT INFORMATION PHYSICIAN INFORMATION Name : Name ID Number . Specialty D ate of birth : Male Female . Address Diagnosis (include ICD-10) City /State/Zip Drug Name Phone: ( ) - F. ax: ( ) - Dose and Quantity ...The UAW Retirees of the Dana Corporation Health and Welfare Trust, (the “Trust”) provides health care benefits for retired eligible UAW retirees from Dana Corporation, along with their eligible dependents. Currently, the Trust provides health care benefits to more than 3,500 retirees plus dependents. This arrangement was made possible ...