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REQUEST FOR MEDICARE PRESCRIPTION DRUG COVERAGE DETERMINATION This form may be sent to us by mail or fax: Address: Blue Cross Medicare Advantages Attn: Clinical Review Department 1305 Corporate Center
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The clinical review department is responsible for reviewing and evaluating medical records and treatment plans to ensure quality of care.
Healthcare providers, insurance companies, and other entities involved in the management of patient care may be required to file with the clinical review department.
To fill out the clinical review department forms, provide accurate and detailed information about the patient's medical history, current condition, and proposed treatment plan.
The purpose of the clinical review department is to ensure that patients receive appropriate and effective medical care by reviewing and approving treatment plans.
Information such as patient demographics, medical history, diagnosis, treatment plan, medications, and any other relevant medical information must be reported to the clinical review department.
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