Medical Injectable Drug Program

Highmark Blue Shield has a streamlined program through which all PremierBlue^SM 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 PPOBlue^SM, DirectBlue^®, EPOBlue^SM, 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.

• List of drugs that are included in the program

• Referral forms by therapy/drug

• 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