Requesting chemotherapy drug prior authorization for Geisinger Gold members through OncoHealth
As of Thursday, May 23, Medicare Part B chemotherapy drugs for Geisinger Gold members will require prior authorization through OncoHealth.
Geisinger Health Plan is working with OncoHealth to implement a new oncology benefits management program in 2024. The program will initially be limited to Medicare Part B chemotherapy medical benefit drug authorizations for Geisinger Gold members.
Later this year, the program will expand to include prior authorization management for other chemotherapeutic drugs, symptom management drugs, supportive agents, radiation therapy drugs and molecular genetic testing. The program will continue to expand throughout 2024 to encompass oncology prior authorization for Geisinger Health Plan offerings beyond Geisinger Gold and provide cancer care support services to members.
Beginning May 23:
- New medical benefit drug prior authorization processes apply only to Geisinger Gold members.
- If you prescribe Medicare Part B chemotherapeutic drugs for Geisinger Gold members, you’ll need to request these medical benefit drug prior authorizations through OncoHealth.
- There is no change to the list drugs that require prior authorization at this time. Check our prior authorization list for current prior authorization requirements.
Reauthorization of previously approved requests for Medicare Part B chemotherapeutic drugs
- Authorizations previously issued by Geisinger Health Plan before the implementation date will be effective until the authorization expiration date.
- As of May 23, new authorization requests for Geisinger Gold Medicare Part B chemotherapy medical benefit drugs must be submitted to OncoHealth.
What you should do before May to prepare
Watch for outreach from OncoHealth. The OncoHealth provider relations team will soon share information on a webinar series and training that will give you an overview of OncoHealth, how the oncology management program works and what you can expect from it.
About OncoHealth
OncoHealth offers providers, patients and health plans an evidence-based, technology-driven approach to medical oncology management. OncoHealth supports providers in the United States and Puerto Rico, providing patients with the ability to achieve the best possible outcomes in their cancer care. This has been accomplished by facilitating the continuous access to current, evidence-based, disease-specific analytics on all cancer types, stages and treatment options, backed by our board-certified oncologists/hematologists, radiation oncologists, pharmacists and nurses. OncoHealth promotes evidence-based treatments that consider all therapeutic options based upon objective assessments of efficacy, safety and cost-effectiveness.
How to request authorization
Request an authorization for Medicare Part B chemotherapeutic drugs using one of the following methods:
- Web: oneum.oncohealth.us
- Fax: 800-264-6128
- Phone: 888-916-2616
How to confirm authorization
- Ordering providers: A dashboard inside of OncoHealth’s provider portal, OneUM, makes it easy to view the status of your prior authorization requests
- Servicing providers: Upon determination, a notification is sent to the servicing provider from OncoHealth
Have questions?
- For questions on submitted requests, requesting reconsideration, making updates to a case or to talk with a provider or nurse about a case, call 888-916-2616 or email info@oncohealth.us.
- Fax additional requested information or medical records and lab results to 800-264-6128.
- For questions about credentials, system access or any technical issues before submitting a prior authorization request, email clientsupport@oncohealth.us.
- OncoHealth will conduct training sessions to familiarize providers with the process. Visit OncoHealth online today to find a learning opportunity that works for your schedule.
Join an OncoHealth webinar to learn more
OncoHealth will host webinars through Zoom every Thursday starting April 25. Use the links below to register for a morning or afternoon session.
