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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-Determination of Medical Benefits Forms (F-N)

PW_B145640
 
Pre-determinations for Zometa and Neumega will not be required as previously announced. No review is required  
 
Specialty pharmacy management program available online through AIM®
Fabrazyme
Flolan®, Remodulin
Growth Hormones
Halaven
Herceptin
HP Acthar Gel
Humira
Hyaluronan
Hycamtin
Ilaris
Immune Globulin
Jevtana
Leukine/Prokine
Lumizyme Myozyme
Lupron
Mozobil
Naglazyme
Neulasta
Neupogen
Nplate
Nulojix
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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.