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Medical Policy, Clinical UM Guidelines, and Pre-Cert Requirements

View requirements for Local Plan and BlueCard Out-of-Area members.

Search our online provider directory when you need a doctor, hospital, or other health care provider.

Pre-Service Medical Benefit Review for Specialty Drugs

PW_A103227
 
Pre-determinations for Zometa and Neumega will not be required as previously announced. No review is required. 
**If you are completing one of these forms for a SHBP member, please fax the form to
1-855-410-4455.**
 
 
Pre-Determination of Medical Benefits Forms  
Forms A-E
Forms F-N
Forms O-S
Forms T-Z
 
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Blue Cross and Blue Shield of Georgia, Inc. and Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association.