Effective August 1, 2023, Part B provider-administered drug precertification is required for your Blue Advantage^® patients. Precertification will be managed by Magellan Rx Management.

Precertification is required for the drugs on the Blue Advantage Part B Provider-Administered Precertification Drug List when administered in a provider’s office, outpatient facility or home health setting.

Note: Gene therapy/cellular immunotherapy drugs indicated on the drug list require precertification in all places of treatment.

Patients receiving medication on the precertification drug list prior to August 1, 2023, have an authorization in our system through December 31, 2023, for continued claims payment. On January 1, 2024, continued coverage will require valid precertification through Magellan Rx.

You can submit precertification requests to Magellan Rx through the existing Pre-Service Review process:

1. Log in to myBlue Provider and select Blue Advantage Pre-Service Review under the Prior Authorization menu on the left side.
    

   
    

2. Next, click the GO button to initiate the precertification process.
    

   
    

Urgent precertification requests can be submitted by contacting Magellan Rx at 1-800-424-8270.

Refer to our Pre-Service Review Guide as well as our Part B Provider-Administered Drug Precertification Provider Training Guide for details.

Our medical and drug policies can be found by logging in to myBlue Provider and clicking on Blue Advantage Resources.

Magellan Rx Management^SM is an independent company providing medical review services on behalf of Patrius Health.