BCBSND policy information and prior authorization tools are available here to help you understand the claims edit logic used to determine when and how benefits are extended.
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BCBSND policy information and prior authorization tools are available here to help you understand the claims edit logic used to determine when and how benefits are extended.
BCBSND contracts with eviCore for its Laboratory Management Program. Services apply to all members in accordance with their benefit plan policy. Effective 1-1-2020 Lab Management (molecular and genomic testing) is delegated to eviCore.
eviCore is an independent company providing benefits management on behalf of Blue Cross Blue Shield of North Dakota.
View Retail Pharmacy Medical Policies
Retail pharmacy medical policy provided by Prime Therapeutics. Prime Therapeutics is an independent company that assists in the administration of BCBSND's pharmacy benefits management on behalf of Blue Cross Blue Shield of North Dakota.
Some medical procedures and services require prior authorization to qualify for benefits. Providing thorough information will help BCBSND establish the medical appropriateness of specified services and extend benefits.