Medications covered by medical benefits that you administer
If you are administering medication to a member in your office or in an outpatient setting, we encourage you to take these steps:
|Step||Check member benefits and eligibility. Log in and use a self-service technology or contact us.|
|Step||Determine whether authorization for the medication is required.
Refer to our Medical Utilization Management (MED UM) & Pharmacy Prior Authorization Policy (033) or our Medical Utilization Management (MED UM) Drug List (034).
If authorization is required, submit the Massachusetts Standard Form for Medication Prior Authorization Request (eForm).
Federal Employee Program members
|Step||Perform the service and submit your claim.|