Quicker Access to Online Pharmacy UM Programs

Beginning this Friday, you’ll be able to access the online information and fax forms you need that pertain to our pharmacy utilization management (UM) program for our commercial members much more quickly and efficiently. 

This new site – www.bluecrossnc.com/umdrug – provides you with an alphabetical listing of all of the drugs that require review by Blue Cross and Blue Shield of North Carolina (Blue Cross NC).    If the drug requires prior review, quantity limitation exception requests, or is subject to restricted access/step therapy, you’ll find the specific requirement criteria, additional information, formularies, and related fax forms you need on this one page.

We will update the site 90 days in advance of any new review requirement, as well as continue to update you via the Provider News page.  New-to-market drugs may also appear on this site, with less than 90-day notice, but only if no Blue Cross NC members have filled a prescription for the particular drug in question.  You will continue to be notified of these new-to-market drugs via the Provider News page.

By using www.bluecrossnc.com/umdrug , you and your staff will save valuable time knowing exactly where to go online to get the medication-related utilization management information you need when you need it.

Please note that this new site does not apply to the State Health Plan, Federal Employee Program, or Blue Medicare^SM.  You’ll need to check the drug utilization program information for those specific types of coverage, in order to determine their specific requirements.

If you have questions, please contact the Provider Blue LineSM at 1.800.214.4844.