Renflexis^® requires authorization for BCN Advantage^SM starting Oct. 1

For dates of service on or after Oct. 1, 2018, Renflexis requires authorization for BCN Advantage members.

This medication is not self-administered. It must be given by injection or infusion by a physician or health care professional in the office, home or outpatient facility setting.

This medication requires authorization when it is billed on either a professional HCFA 1500 claim form (or submitted electronically using an 837P transaction) or on a facility claim form such as the UB-04 (or submitted electronically using an 837I transaction), for the following places of service:

• Physician office (Place of Service code 11)
• Home (Place of Service code 12)
• Outpatient facility (Place of Service codes 19 and 22)

Submit authorization requests for this medication through the Novologix online tool. Authorization must be obtained prior to the medication being administered.

Posted: September 2018
Line of business: Blue Care Network