Medical Injectable Drugs Program

Highmark Delaware has a streamlined program through which all Delaware network physicians may obtain certain medical injectable drugs. Highmark partners with AllianceRx Walgreens Prime (previously, Walgreens Specialty Pharmacy) for this program.

AllianceRx Walgreens Prime is open seven days a week and offers several delivery options as well as patient counseling and monitoring of your refill needs. They can be reached at 1-888-347-3416 or 412-231-3777. The fax number for the Pittsburgh location is 877-235-9807.

AllianceRx Walgreens Prime bills Highmark and ships to the medical provider. Financial assistance resources are available to patients who qualify. (Please note: If a patient seeks financial assistance, this can delay delivery of the drug.)

  • List of drugs that are included in the program
  • Referral forms by therapy/drug
  • Below is the necessary information that should be provided to Walgreens Specialty Pharmacy to limit and reduce the additional outreaches to the Provider's office.

    • Patient name, address, DOB
    • Date needed
    • Diagnosis code in ICD10 format
    • Patient weight
    • Prescription Insurance Information
    • Drug name and strength
    • Directions
    • Quantity
    • Refills
    • MD Signature, address, and contact information
    • Date written
    • Allergies, Medical conditions, and concurrent medications
    • Prior authorization numbers or information if already obtained

Any other additional information required on the therapy/drug specific referral form

Last updated on 2/20/2019

 

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