Carelon Medical Benefits Management Cancer Treatment Pathways Inquiry Form- Anthem, Amerigroup, BCBSNC

Carelon Medical Benefits Management Cancer Treatment Pathways Inquiry Form

You are welcome to use this form to submit inquiries about Carelon Medical Benefits Management Cancer Treatment Pathways.

DO NOT USE THIS FORM TO INQUIRE ABOUT A SPECIFIC ORDER REQUEST. Order requests must be processed through provider portal or our contact center.

Full Name*

First NameLast Name

Credentials*

If other credentials

E-mail*

Phone Number*

Area CodePhone Number

Program that you are inquiring about

Type of organization you represent*

other, please explain

Inquiry*

If you would like to submit supporting documentation or literature along with your inquiry, please upload that documentation here.

Note that when developing Cancer Treatment Pathways, Carelon uses widely accepted sources of medical necessity criteria, including the National Comprehensive Cancer Network (NCCN), the American Society of Clinical Oncology (ASCO), the National Cancer Institute (NCI), and peer-reviewed scientific literature. Carelon does not review or accept unpublished information or information summarized by a pharmaceutical sponsor.

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If you are submitting information to inform a Cancer Treatment Pathway, your message will be considered during the course of our regularly scheduled review cycle. Because of the large quantity of literature reviewed during each pathway review cycle, we are unable to respond to individual submissions.