Posted in Insurance, Training, Updates

BCBS North Carolina-change to Medications Prior Authorization process 04/28/21 & 06/16/21

The Process will be in 2 phases.

Phase 1 will begin on 04/28/21- on or after this date BCBS NC will transition to Cover My Meds and the pharmacy call center team, from Care Radius.

Partial Lis of Phase 1 medications:

During Phase 1 providers should still use existing process (i.e., Care Radius or 800-571-7942), to request prior authorizations for medications that are NOT on the PHASE 1 list.

Phase 2- will begin on or after 06/16/2021 and providers will need to contact Cover My Meds or pharmacy call center team, to request an authorization.

Below is partial list for Phase 2 medications:

How to request an authorization:

Please note: Phase 1 medical drug Corporate Medical Policies and associated fax forms will be moving to We will notify you when this shift occurs via another news article. Once this move occurs, you may notice some formatting/layout changes to policies. If there is a policy change, this will be communicated separately. 

To see the whole list of Phase 1 and Phase 2 medications please click here.

#priorauthorizations, #medications, #covermymeds



My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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