Prevent unnecessary delays: Include key information for oncology pharmacy prior authorization drug requests

Help deliver effective therapy to your patients and ensure proper use of medications by providing key information with your oncology pharmacy prior authorization drug requests.

Prevent oncology medication claim processing delays
Send all oncology pharmacy prior authorization drug requests with:

• Recent chart notes
• Diagnosis
• Documentation of trials and failures of alternatives

If you don’t include chart notes with your oncology pharmacy prior authorization drug requests, your request may be denied. Chart notes are:

• Useful for verifying dosing regimens and patient usage
• Required if a patient continues therapy that began in a hospital setting
• Especially important for cancer patients on chemotherapy

Documentation of diagnosis, as well as trials and failures of alternatives ensure that you’re following the most up to date oncology prescribing guidelines.

For more information about our utilization management criteria for oncology medications, visit the Prior Authorization and Step Therapy Guidelines web pages for Blue Cross Blue Shield of Michigan PPO or Blue Care Network HMO plans.