Buckeye Provider Guide

for Quantitative Drug Testing for Drugs of Abuse

Effective 11/1/14 Buckeye Community Health Plan will begin requiring prior authorization as a condition of payment for Quantitative Testing for Drugs of Abuse.

The ordering provider should request prior authorization for Quantitative Drug Testing for Drugs of Abuse. Refer to the information below for guidance regarding how to obtain prior authorizations from Buckeye.

FREQUENTLY ASKED QUESTIONS:

How do I determine if a test is a Quantitative Drug Test for Drugs of Abuse?

• You may determine which specific codes require prior authorization by visiting our website at www.bchpohio.com and clicking on the Prior Auth Needed tab. The Prior Auth Needed tab will take you to our PreScreen Tool. Just enter the CPT code and the PreScreen Tool will advise you whether the service requires prior authorization or
• The enclosed spreadsheet listing the updated codes which require prior authorization.

How do I request a prior authorization for these services?

• You may submit the prior authorization request utilizing our Secure Web Portal at www.bchpohio.com. If your request is not approved, you will receive verification through the Secure Web Portal. If you are not currently registered on our Secure Web Portal, you may register through a quick and simple process.
• You may submit the prior authorization request by faxing an authorization to:
  • Central/Southeast Region – Columbus PA Fax Number 855-339-5145
  • Northeast Region – Akron PA Fax Number 866-535-4083
  • Northeast Region – Cleveland PA Fax Number 866-529-0290
  • West Region – Cincinnati/Dayton PA Fax Number 866-529-0291
  • West Region – Toledo PA Fax Number 866-535-4084
  • The fax authorization form can be found on our website at www.bchpohio.com.
  • You may call our Medical Management department at 866-246-4359.

What information will I be required to submit in connection with the prior authorization request?

• CPT code
• Diagnosis Code
• Rendering laboratory provider’s name, Tax ID number, and NPI number.

If you have any questions regarding this information, you may contact Provider Services at 866-296-8731 or www.bchpohio.com.

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When the services below are Covered Services, the services require Prior Authorization.

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When the services below are Covered Services, the services require Prior Authorization

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