Notification is required so the Navigation Team can guide and support members who require costly or complex care.
For additional information about the Navigation Team please refer to the Navigation Team FAQ section.
When is Notification required?
Members are required to complete the Notification process as indicated by Healthcare Bluebook* in advance of seeking certain care, including:
Cancer Diagnosis or treatment (including medication)
Organ/tissue transplant services
Specialty medications (including infusions/injections given at home or in a doctor’s office)require pre-notification to our pharmacy partner, Navitus, call 833- 837-4307. You can also call with prescription questions or visit memberportal.navitus.com to search pricing at local pharmacies for non-specialty medications.
Any time the procedure or services are anticipated to exceed $5,000
Any time Healthcare Bluebook* indicates notification is required