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Pharmacy Benefits

Details: The carve-out list (PDF) includes medicines used for HIV, hepatitis C, cystic fibrosis, seizure disorders, sleep problems and some behavioral health issues. The pharmacy will need your MIHealth card or your Medicaid ID number to process carve-outs. Members 21 and older will pay a small fee for carve-outs.

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Pharmacy Reference Guide

Details: Our preferred Specialty Pharmacy to dispense specialty medications is Perform Specialty, phone: 1-855-287-7888. Blue Cross Complete’s D.0 Payer Sheet (PDF) contains Blue Cross Complete’s BIN (600428), PCN (06210000), member :

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Home [www.mibluecrosscomplete.com]

Details: We also offer pharmacy, maternity care and integrated care management benefits. The Healthy Michigan Plan is a health care program from the Michigan Department of Health and Human Services. Blue Cross Complete administers Healthy Michigan Plan benefits to …

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Pharmacy Network File

Details: WALMART PHARMACY 10-5925 2305 JORDAN LN SW HUNTSVILLE: AL 35805: Madison County 256-755-3079: 256-755-3078 N: 10AM - 06PM 09AM - 09PM: 09AM - 07PM Y: www.walmart.com Community/Commercial/Retail Out-of-State: WALMART PHARMACY 10-7324 2165 WINCHESTER RD NE HUNTSVILLE: AL 35811: Madison County 256-716-6771: 256 …

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Find a Doctor, Pharmacy or Dentist

Details: You can find a Blue Cross Complete doctor or pharmacy using our online search. If you're pregnant or enrolled in the Healthy Michigan Plan, you can also find a dentist. Get started below. If you have questions or need assistance, call Customer Service at 1-800-228-8554. TTY users should call 1-888-987-5832.

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MCG message Blue Cross Complete pharmacy COVID

Details: COVID-19 diagnosis code and the pharmacy understands the prescription is for the treatment of COVID-19, the pharmacy shall submit the Prior Authorization Type Code value of “4” (4 = Exemption from Co-pay and/or Co -insurance) in NCPDP Field 461-EU. Suppression of COVID-19 related service co-pays and pharmacy co-pays will be in effect

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Provider communication

Details: Pharmacy claims reimbursement for home administration of COVID-19 vaccines requires submission of Place of Service = 12 in NCPDP field 307-C7. According to the CMS Place of Service Code Set, 12 is defined as “location, other than a hospital or other facility, where the

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Preferred Drug List

Details: This Preferred Drug List is a list of medicines that are covered by your pharmacy benefit. The list includes prescription and non-prescription medicines. In addition to this list, you can use our online search tool. You’ll also find the Preferred Drug List Quick Reference on our website at mibluecrosscomplete.com. This is an easy-to-use

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MDHHS Health Plan Pharmacy Programs Carve -Out

Details: MDHHS Health Plan Pharmacy Programs Carve -Out SUBMITTED TO MAGELLAN MEDICAID ADMINISTRATION, Inc. POINT-OF-SALE Updated 11/30/2020 Page 1 of 4 . Code Description . A7N Plasma Kallikrein Inhibitors . Added 10/1/2012 . B0B

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Self-Service Tools

Details: Pharmacy billing The electronic processing of retail pharmacy claims requires a NCPDP processor ID number, also known as a BIN, and a processor control number, or a PCN, for plan identification. Blue Cross Complete's D.0 Payer Sheet (PDF) contains our BIN (600428), PCN (06210000), member services number, field definitions and other helpful

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Attention Pharmacy Providers Single Preferred Drug List

Details: Independent pharmacy dispensing fee change. Beginning October 1, 2020, Medicaid health plans are contractually required to pay at least a $3.00 professional dispensing fee per prescription to pharmacies with a Community Health Automated Medicaid Processing System (CHAMPS) provider specialty of ‘Independent’.

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Blue Cross Complete of Michigan Pharmacy Network Page 1 …

Details: cvs pharmacy # 10811 1218 university blvd tuscaloosa al 35401 tuscaloosa county 401-765-1500 n 10am - 06pm 08am - 08pm 09am - 08pm n/a walmart pharmacy 10-5256 4201 hargrove rd e tuscaloosa al 35405 tuscaloosa county 205-632-6150 205-632-6203 n 10am - 06pm 09am - 09pm 09am - 07pm n/a

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2021 Payer Sheet NCPDP Version D

Details: 147-U7 PHARMACY SERVICE TYPE RW Imp Guide: Required when the submitter must clarify the type of services being performed as a condition for proper reimbursement by the payer. Payer Requirement: (Same as Imp Guide). Pricing Segment Questions Check Claim Billing/Claim Rebill If Situational, Payer Situation This Segment is always sent X Pricing

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Healthy Michigan Plan

Details: Pharmacy: $1 preferred $3 non-preferred. $4 preferred $8 non-preferred. Vision care visit. $2: $2: Dental care visit. $3. $4. Hearing aids. $3 per aid. $3 per aid. Chiropractic visit. $1: $3: Podiatry visit. $2: $4: Emergency room visit for non-emergencies (no copay for emergency services) $3: $8: Outpatient hospital visit. $1: $4: Inpatient

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Medication Prior Authorization Request

Details: Attention Pharmacy at 1-855-811-9326 By mail: PerformRx, Attention: 4. th. Floor Prior Auth Dept 200 Stevens Drive, Philadelphia, PA 19113. Note: Blue Cross Complete's prior authorization criteria for a brand-name (DAW) request: Documentation of an adverse event or lack of efficacy with the generic formulation . and . completion of an . FDA

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Provider Programs

Details: Refer to the Pharmacy Reference Guide (PDF) for a quick reference about pharmacy provider services, prior authorizations, member copays, durable medical equipment covered under pharmacy and recipient restrictions. Blue Cross Complete is a member of the Michigan managed care common formulary workgroup.

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Member Advisory Council

Details: Member Advisory Council. The Member Advisory Council provides a place for members, advocacy groups and providers to give input into Blue Cross Complete of …

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Diabetes Monitoring

Details: your local pharmacy with a prescription. The Accu-Chek® Guide monitor is the preferred formulary blood sugar monitor. Ask your provider to write for this monitor and supplies. If you have an Aviva or Nano meter and would prefer to continue using it, the supplies for both monitors remain covered for you. When you

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Dual Eligible Preferred Drug List

Details: This Preferred Drug List is a list of medicines that are covered by your pharmacy benefit. The list includes prescription and nonprescription medicines.- In addition to this list, you can use our online search tool. You’ll also find the Preferred Drug List Quick Reference on our website at mibluecrosscomplete.com. This is an easy-to-use

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Health risk assessment

Details: The Health Risk Assessment is an aid to help members improve their health. It helps doctors and the health plan ensure that members get enrolled into health education programs geared toward their specific health needs. By completing the assessment and committing to a healthy behavior each year, you may qualify for reductions in your cost

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Preferred Drug List SECURE

Details: This Preferred Drug List is a list of medicines that are covered by your pharmacy benefit. The list includes prescription and non-pre scription medicines. In addition to this list, you can use our online search tool. You’ll also find the Preferred Drug List Quick Reference on our website at mibluecrosscomplete.com. This is an easy-to-use

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Blue Cross Complete of Michigan authorization requirements

Details: available at mibluecrosscomplete.com on the Pharmacy Benefits page, under Prior authorization. The complete form must be faxed to PerformRX at 1-855-811-9326 or mailed to PerformRX at the address on the form. Obesity surgery Services require authorization. Requests must be submitted at least 14 days prior to service being rendered.

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Specialty Drug List PH-ANR07Rev022119

Details: F = Formulary PA = Prior Authorization QL = Quantity Limit ST = Step Therapy AL = Age Limit . V01.01.2019 . 1 . Drug Tier Status Notes

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Vision and Hearing

Details: Batteries, maintenance and repair for hearing aids. Hearing exams and hearing aid evaluations are available from a network provider. Go to Find a Doctor, then search for “hearing aid.”. If you have questions about this benefit, contact Customer Service at 1-800-228-8554. TTY users should call 1-888-987-5832.

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2021 Blue Dot Changes to the Blue Cross Complete Provider

Details: • Section 12 - Pharmacy Services - (p. 73): Added clarification on exception policy for all prescriptions and added information where the maintenance drug list can be accessed at michigan.magellanrx.com. Added information and other details for drugs on the Maintenance

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News and Updates

Details: COVID-19 vaccine pharmacy billing and reimbursement update (PDF) MDHHS urges providers to enroll now for COVID-19 vaccination of children ages 12 and under (PDF) COVID-19 vaccination status report available on NaviNet beginning Aug. 11, 2021 (PDF) COVID-19 vaccine enhanced administration fee (PDF)

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Blue Cross Complete authorization requirements

Details: Changes from previous publication are identified by a blue dot and explained on the final page of this document. 2020 Plan Notification and Authorization Requirements

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Mental health services

Details: Customer Service can help you find a network mental health provider in your area. Call 1-800-228-8554. TTY users should call 1-888-987-5832. If you need emergency care for a life-threatening condition, or if you’re having thoughts of suicide or death, go to the nearest emergency room or call 911.

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Preventing the Flu

Details: Preventing and Treating the Flu. According to the Centers for Disease Control and Prevention, getting a flu shot can reduce your risk of getting the flu by 50 to 60 percent. It’s recommended that all people 6 months and older receive the flu shot each year. Getting a flu shot is easy, and with your benefits, it's at no cost to you.

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