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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 (O-S)

PW_B145641
 
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®
Ocriplasmin
Opdivo
Orencia
Perjeta
Pharmacotherapy for Heriditary Angioedema
Praluent
Prialt
Proleukin®
Prolia
Provenge
Remicade
Retinal Vascular
Rituxan®
Sandostatin
Simponi
Soliris
Stelara
Sylvant
Synagis
 
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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.