Print, type or write legibly in blue or black ink. See reverse side for additional details. Once a clinical decision has been made, a decision letter will be mailed to the patient and physician. For other …

If you have questions about the IBX preapproval process, call 1-800-ASK-BLUE. For Independence Administrators providers, please contact Customer Service at 1-888-356-7899. Please refer to the …

Conveniently submit requests at the point of care through the patient’s electronic health record. If the EMR/EHR does not support ePA, you can use one of these vendor portals: Adobe Acrobat Reader is …

Jan 26, 2026 · Call us: 8 a.m. to 5 p.m. EST, Monday through Friday.

Before you get started, in addition to your insurance card, you will need the following information. This information can be obtained by contacting your prescribing physician.

Prior Authorization, Step Therapy, and Quantity Management. COVERAGE MANAGEMENT PROGRAMS The purpose of coverage management programs is to help improve the quality of care …

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Jan 1, 2024 · Blue Cross and Blue Shield of North Carolina is a HMO/PPO/PDP plan with a Medicare contract. Enrollment in Blue Cross and Blue Shield of North Carolina depends on contract renewal.

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Print, type or WRITE LEGIBLY and complete form in full. If approved, the payor will forward to the exclusive specialty vendor. The exclusive specialty vendor can be reached at 888-347-3416. Note: If …