Prior Authorization Updates
Providers, you can check this section of the website for any changes to the Buckeye Prior Authorization policies/processes.
Update Posted December 18, 2012:
We know that recently you’ve been experiencing some issues with J9035 and J9355 authorizations and we apologize for any inconveniences this may have caused. Our goal is to continue to work with you to help ensure that you are able to provide your patients the best care possible.
Effective, February 1, 2013, all participating Hematologists and Oncologists will be required to receive prior authorization before administering injectable drugs with costs over $250. If drugs are administered without authorization, the claim will be denied and the provider will not receive payment. There are some exceptions to this policy, so please call Provider Services to determine if a drug needs prior authorization.
We are reviewing denials weekly for claims that have been denied due to the new authorization requirements and will override these denials until January 31.