Access to BCBSND policies and prior authorization

BCBSND policy information and prior authorization tools are available to help you understand the claims edit logic used to determine when and how benefits are extended. 

Genomic Testing Policy

Non-migrated members BCBSND contracts with EviCore by Evernorth (EviCore) for its Laboratory Management Program. Services apply to all non-migrated members in accordance with their benefit plan policy. Laboratory Management (molecular and genomic testing) is delegated to EviCore. 

Migrated members: Laboratory management policies and prior authorization for molecular and genomic testing will be managed by BCBSND.

EviCore is an independent company providing benefits management on behalf of Blue Cross Blue Shield of North Dakota (BCBSND).

Additional Policies

Retail benefit drug policies are administered by Prime Therapeutics, an independent company contracted to provide pharmacy benefits management services on behalf of BCBSND.

View Retail Benefit Drug Policies

Medical benefit drug policies are administered by Prime Therapeutics Management LLC, a subsidiary of Prime Therapeutics LLC, a pharmacy solutions provider contracted to provide these services for BCBSND.

View Medical Benefit Drug Policies