Medical Injectable Drug Program

Highmark Blue Shield has a streamlined program through which all PremierBlueSM Shield network physicians must obtain certain medical injectable drugs. Physicians must use the program to obtain these drugs for their Medicare Advantage (FreedomBlueSM) patients.

The program is optional for PPOBlueSM, DirectBlue®, EPOBlueSM, BlueCare® PPO,* Federal Employee Health Benefits Program (FEP), and BlueCard® patients.

Highmark Blue Shield partners with AllianceRx Walgreens Prime (previously, Walgreens Specialty Pharmacy) for this program.

* Alpha prefixes QEE, SNQ, and AUV only.

AllianceRx Walgreens Prime is open seven days a week and offers several delivery options as well as patient counseling and monitoring of your refill needs. They can be reached at 1-888-347-3416.  The fax number for the Pittsburgh location is 1-877-231-8302.

AllianceRx Walgreens Prime bills Highmark and ships to the medical provider. Financial assistance resources are available to patients who qualify. (Please note: If a patient seeks financial assistance, this can delay delivery of the drug.)

Highmark Blue Shield does not reimburse network physicians for products included in the Medical Injectable Drug Program.

  • Below is the necessary information that should be provided to AllianceRx Walgreens Prime to limit and reduce the additional outreaches to the Provider's office. 

    • Patient name, address, DOB
    • Date needed
    • Diagnosis code in ICD10 format
    • Patient weight
    • Prescription Insurance Information
    • Drug name and strength
    • Directions
    • Quantity
    • Refills
    • MD Signature, address, and contact information
    • Date written
    • Allergies, Medical conditions, and concurrent medications
    • Prior authorization numbers or information if already obtained
    • Any other additional information required on the therapy/drug specific referral form
Last updated on 3/20/2019

 

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