Medical Benefit Drugs: Resources
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Shared resources
- Using the RC Claim Assist tool: Frequently asked questions for providers
— RC Claim Assist is a web-based resource available to Blue Cross Blue Shield of Michigan and Blue Care Network contracted providers who bill for drugs covered under the medical benefit. RC Claim Assist provides an inclusive overview of medical drug products and a calculation tool to identify the correct National Drug Code and CPT codes to bill, along with the correct NDC quantity, unit of measure and HCPCS billable units according to the package information. - Billing instructions: Reporting the NDC
- Inquiries about drugs covered under the medical benefit: Frequently asked questions for providers
- Billing instructions: Using modifiers JW and JZ
- Drugs: For medication discounts, adherence and prior authorization determinations — Includes information about our care management and utilization management programs
- Oncology: For cancer support, oncology drugs and radiation oncology — Includes information about our care management and utilization management programs
- Alternate methods for submitting prior authorization requests for medical and pharmacy benefit drugs — Provides alternate methods to submit prior authorization requests if you’re experiencing temporary technical problems that prevent you from submitting requests electronically
Blue Cross commercial and BCN commercial resources
- The Record articles
- BCN Provider News articles
- Lemtrada and Tysabri site-of-care program: FAQ
- In-network home infusion therapy providers and ambulatory infusion centers
- Audaire Health™:
- Audaire Health tracking program: FAQ
- Audaire Health — Provider User Guide
- Audaire Health Provider Portal
- Medical Policy Router
- Changes to medical necessity criteria for prior authorizations for medical benefit drugs
- Blue Cross and Blue Shield FEP medical policies
Frequently accessed documents
Additional resources
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