Gateway Health Plan Prior Authorization List

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Medications to Require Medical Prior Authorization

(4 days ago) WEBHealth benefits or health benefit administration may be provided by or through Highmark Wholecare, coverage by Gateway Health Plan, an independent licensee of the Blue …

https://content.highmarkprc.com/Files/Wholecare/Updates/J_CodePriorAuthFeb22Care.pdf

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Prior Authorization Criteria Non-Formulary Medications

(7 days ago) WEBPRIOR AUTHORIZATION FORM Please complete and fax all requested information below including any progress notes, laboratory test results, or chart documentation as …

https://fm.formularynavigator.com/FormularyNavigator/DocumentManager/Download?clientDocumentId=qWDR5gCN5kyyJkc4QC1LlQ

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Prior Authorization Code Lookup - Highmark Health Options

(Just Now) WEBReview the Prior Authorizations section of the Provider Manual. Call Provider Services at 1-844-325-6251, Monday–Friday, 8 a.m.–5 p.m. Or contact your Provider Account Liaison.

https://www.highmarkhealthoptions.com/providers/prior-auth-lookup.html

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Medical Assistance Drug Search Highmark Wholecare

(2 days ago) WEBYou can search the formulary alphabetically by selecting the first letter of the brand or generic name of the drug you are looking for. You can also search by entering the first …

https://www.highmark.com/wholecare/medicaid/member-resources/medication-information-center/drug-search

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Provider Resource Center

(8 days ago) WEBHow to Use the Provider Portal Search Tool. Language Form. Lead Screening Analysis Form. MA30 - Hysterectomy English. MA30 - Hysterectomy Spanish. …

https://wholecare.highmarkprc.com/Medicaid-Resources/Forms-Reference-Materials

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Gateway Health Plan Pharmacy Division - MMITNetwork

(7 days ago) WEBGateway Health Plan Pharmacy Division Phone 800-392-1147 Fax 888-245-2049 I. Requirements for Prior Authorization of Hypoglycemics, Insulin and Related Agents A. …

https://fm.formularynavigator.com/FormularyNavigator/DocumentManager/Download?clientDocumentId=y4OpuRnDmE2oUVSqn13tHg

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NON-PREFERRED MEDICATION PRIOR AUTHORIZATION …

(7 days ago) WEBGateway Health Plan Pharmacy Division Phone 800-392-1147 Fax 888-245-2049 . I. Requirements for Prior Authorization of Ophthalmics, Antibiotic-Steroid Combinations. …

https://fm.formularynavigator.com/FormularyNavigator/DocumentManager/Download?clientDocumentId=gLTlp3Koh069xCEP5Lwz4g

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Pennsylvania Medicaid and Medicare Insurance

(Just Now) WEBPennsylvania Community Roots. Highmark Wholecare calls Pennsylvania home. We know that working in our communities helps us offer whole care to our neighbors. We proudly have: More than 400,000 …

https://highmark.com/wholecare

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Medications to Require Medical Prior Authorization

(4 days ago) WEBHealth benefits or health benefit administration may be provided by or through Highmark Wholecare, coverage by Gateway Health Plan, an independent licensee of the Blue …

https://content.highmarkprc.com/Files/Wholecare/updates/J_CodePriorAuthApr23Caid.pdf

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Provider Resource Center

(5 days ago) WEBSession 1: Tuesday, September 17 – 10:00 AM -12:00 PM EST. Session 2: Tuesday, September 24 – 2:00 PM- 4:00 PM EST. You can click the link below to …

https://wholecare.highmarkprc.com/Provider-Resources/Netsmart-Electronic-Visit-Verification-EVV

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Provider Resource Center

(4 days ago) WEBImportant Electronic Visit Verification (EVV) Vendor Update. 8/20/2024. Claim Education: New Patient Vs. Established Patient Webinar. 8/20/2024.

https://wholecare.highmarkprc.com/

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Medicare Medication Formulary and Benefits - Highmark

(1 days ago) WEBYou can also call Member Services at 1-800-392-1147 (TTY 711). See which medications are covered by Medicare and explore our medication formulary for 2023. Choose …

https://www.highmark.com/wholecare/medicare/benefits-programs/medication-benefits/formulary

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I. Requirements for Prior Authorization of Stimulants and

(7 days ago) WEBThe information is intended only for the use of the individual named above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution …

https://fm.formularynavigator.com/FormularyNavigator/DocumentManager/Download?clientDocumentId=Wm3NfJep0U2ANIFDGz2K5w

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Statewide Preferred Drug List Information - PA.GOV

(7 days ago) WEBThe Department of Human Services ("the department") maintains a Statewide Preferred Drug List (PDL) to ensure that Medical Assistance (MA) program beneficiaries in the …

https://www.pa.gov/en/agencies/dhs/resources/pharmacy-services/preferred-drug-list.html

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Highmark Wholecare Resource Center by findhelp - Search and …

(1 days ago) WEBSearch and connect to support on the Wholecare Resource Center to find food assistance, help paying bills, and other free or reduced cost programs. If you or someone you know …

https://wholecareresources.com/

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Prior Authorization & Referrals :: The Health Plan

(6 days ago) WEBPharmacy Prior Authorization and Notification Requirements. To obtain prior authorization, call 1.800.624.6961, ext. 7914 or fax 304.885.7592 Attn: Pharmacy. …

https://www.healthplan.org/providers/prior-authorization-referrals

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Request for Drug Coverage - Highmark

(8 days ago) WEBHealth benefits or health benefit administration may be provided by or through Highmark Wholecare, coverage by Gateway Health Plan, an independent licensee of Request …

https://www.highmark.com/content/dam/digital-marketing/en/highmark/highmarkdotcom/wholecare/wholecare-working-images/documents/pdfs/medicare-grievances-and-appeals/request-for-drug-coverage-form.pdf

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Gateway Health Plan - fm.formularynavigator.com

(7 days ago) WEBGateway Health Plan Pharmacy Division Phone 800-392-1147 Fax 888-245-2049 I. Requirements for Prior Authorization of Contraceptives, Other A. Prescriptions That …

https://fm.formularynavigator.com/FormularyNavigator/DocumentManager/Download?clientDocumentId=v-64Z7dFREmSgZL389ieng

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I. Requirements for Prior Authorization of Opioid

(7 days ago) WEBGateway Health Effective 1/3/22. Plan Pharmacy Division Phone 800-392-1147 Fax 888-245-2049 . I. Requirements for Prior Authorization of Opioid Dependence Treatments. …

https://fm.formularynavigator.com/FormularyNavigator/DocumentManager/Download?clientDocumentId=IB2YbQwok0i4WwX7YZrwdw

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Medicare Health Insurance in PA Highmark Wholecare

(3 days ago) WEBHealth benefits or health benefit administration may be provided by or through Highmark Wholecare, an independent licensee of the Blue Cross Blue Shield Association …

https://www.highmark.com/wholecare/medicare

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Understanding prior authorizations Member - Priority Health

(1 days ago) WEBThere are two parts to the prior authorization process: Your provider submits a request to Priority Health in the electronic authorization portal. The request includes the specific …

https://www.priorityhealth.com/member/getting-care/prior-authorizations

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Contact Us by Phone, Online or Mail Highmark Wholecare

(5 days ago) WEBClinical Provider Appeals: Highmark Wholecare. Attention: Provider Appeals Department. P.O. Box 22278. Pittsburgh, PA 15222. Send us a request by fax to: Non …

https://www.highmark.com/wholecare/contact-us

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