Blue Cross Blue Shield of North Dakota (BCBSND) has changes coming for clinician administered drug prior authorization (also known as precertification or prior approval) requests for our Commercial and Health Insurance Marketplace members. The change coming will affect how providers request prior authorizations for clinician administered drugs on the medical benefit.
BCBSND will be working with the Medical Pharmacy Solutions team at Prime Therapeutics Management (Prime) to assist with clinician administered drug prior authorization reviews. We want to assure providers that BCBSND will be ready later this year to answer provider questions and serve your needs as we move forward.
We will have resources and virtual training sessions available prior to this transition. Watch the HealthCare News section of our website for upcoming news and learning opportunities. To help you navigate these changes, BCBSND will be sending letters to practice managers we determine will be most impacted.
We look forward to collaborating with you and our new administrator to allow your patients and our members access to high-quality health care and medical pharmacy services.
NOTE: This new process will not change the retail pharmacy prior authorization process through the pharmacy benefit (PBM).
Processing...
Please wait while your form is being submitted