Precertification - CATEGORIES

• Blue Cross
• Caremark
• Humana
• Medicaid Radiology PriorAuth
• Medicare Blue
• Provider Forms
• Overrides and Appeals
• Provider Drug List and Resources

Precertification - Links By Category

Blue Cross

• Blue Cross Blue Shield of Nebraska**
  Preauthorization Request Form
• Blue Cross Blue Shield of Nebraska**
  Primary Care Referral/Authorization Form
• Blue Cross Blue Shield of Nebraska**
  Proton Pump Preauthorization Criteria
• Blue Cross Blue Shield**
  Cardiac Rehab Preauthorization Request
• Cox2 Preauthorization Form**
  COX-2 Inhibitors Preauthorization Criteria for Approval
• Cox 2 Fax Form Blue Cross **
  COX-2 Inhibitors Preauth Physician Fax Form
• BC Proton Pump**
  Proton Pump Inhibitors Post Limit
• BC Migraine**
  Migraine Therapy Preauth Criteria
• American CRC
  Nonprofit, bipartisan .

Caremark

• Caremark Celebrex Fax Form **
  Celebrex Step Form Prior Authorization Form
• Caremark Proton Pump
  Proton Pump Inhibitors Post Limit /li>

Humana

• Humana Script Prior Auth Doctor
  Doctor Script Prior Auth
• Humana Script Prior Auth Patient
  Member Script Prior Auth
• Humana Provider Script Tools
  Provider Script tools

Medicaid Precert

• Medicaid Radiology Precert
  MedSolutions Online - 1-888-693-3210 (Medicaid PreAuth)

Medicare Blue

• Medicare Blue Solution**
  Prior Authorization
• Medicare Blue Forms for Providers
  Forms for Providers
• Medicare Blue PPO
  Medicare Part D Formulary or Tier Exception Physician Fax Form

Overrides and Appeals

• My Rx Assistant
  Medicare Blue PPO Overrides and Appeals
• My Rx Assistant**
  Overrides and Appeals
• My Rx Assistant**
  Overrides and Appeals

Provider Drug List and Resources

• American Diabetic Association**
  aaa
• Blue Cross Blue Shield of Nebraska**
  Providers and forms
• Blue Cross Blue Shield of Nebraska**
  Provider submit correction form.
• Medicare Blue Solutions
  aaaa
• Nebraska Department of Health and Human Services
  Division of Medicaid and Long-Term Care
• Nebraska Department of Health and Human Services
  Division of Medicaid and Long-Term Care
• United Health Care