Magellan Rx Management to cooperate with Horizon in its upcoming medical necessity review campaign

The medical necessity of the below-mentioned injectable cancer treatment medications rendered on or after April 1, 2022, will be determined by Magellan Rx Management.

If you are an outpatient healthcare provider furnishing these medications to your patients, please expect to start receiving requests for medical records from Magellan by mid-April. As it was mentioned in the pre-report annotation, this is a pre-payment medical necessity review initiative of Horizon. This means that you will not receive any reimbursement for these injections until the payer determines their medical necessity as soon as the program launches. 
At WCH Service Bureau, we care about your practice. Our team of experienced chart auditors can help you ensure that your medical records are on the same page with the current policies & trends. 
Why wait till April? Contact us to eliminate your future claim denials.
Source:

https://www.horizonblue.com