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Introduction | Prevention | Utilization Management | Disease Management | Case Management


Utilization Management

 

Utilization Management


Inpatient Approval

When you need to go into the hospital, your doctor will work with the Utilization Management team to ensure you receive the right care in the right place at the right time. While you are in the hospital, one of our nurses will review your case and assist with discharge planning or approve additional inpatient hospital days, if necessary.

Prescription Drugs

We take the stress and confusion out of taking prescription drugs by providing the tools to simplify the process of getting your medication. In our Prescription Drug section you can:

  • Download pharmacy claim forms and mail order forms
  • Search the drug database to determine your copay level
  • Get the latest prescription drug news and updates to the preferred drug list

You can also login to My Account, where you can use our pricing tool to to get your prescription at the lowest cost.

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Serving Maryland, the District of Columbia and portions of Virginia. CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc., an affiliate company, also offers health benefit products and services on this site.

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