UP Health System - Marquette Infusion Services is located in the Emergency Department. Click here to access the Campus Map. Our hours of operation are 9:00 am through 5:00 pm, seven days a week dependent upon scheduling. We offer a wide variety of infusion services including blood and blood products, immune globulins, bisphosphonates, antibiotics, and monoclonal antibodies. For those infusions that are commonly utilized and require additional information, we have developed specific order forms that must be completed. If you do not see the specific order form listed at the bottom of this page, please utilize the general order form.
Prior Authorization from Pharmaceutical Manufacturer
Please note that some medications may require authorization from the manufacturer in order to obtain the medication. These requirements are usually mandated by the Food and Drug Administration as ongoing post-marketing safety assessments referred to as Risk Evaluation and Mitigation Strategies (REMS). For additional information on REMS programs, please refer to the FDA website (click here) or the February 2012 issue of the P&T Committee Newsletter (click here). Examples include:
- Natalizumab (Tysabri®) Touch Program (click here to access)
- Belimumab (Benlysta®) Gateway Program (click here to access)
Prior Authorization from Insurance Provider
Prior authorization from insurance companies may also be required and is separate from the REMS programs listed above. Examples of medications commonly requiring prior-authorization include: abatacept (Orencia®), belimumab (Benlysta®), natalizumab (Tysabri®), and tocilizumab (Actema®).
UPHSM Blue Cross of Tennessee:
Prior Authorization Required:
Orencia®, Actemra®, Aranesp®, Benlysta®, Procrit®, Remicade®, Rituxan®, Treanda®, Velcade®, Tysabri®
Medical Necessity Policy:
Immune Globulin (Octagam®), Lumizyme®, Neulasta®, Neupogen®
We understand arranging outpatient infusion services for your patients can be time-consuming and would like to ensure this process is carried out in an efficient manner. To initiate, please send a completed Infusion Center Order Form to Central Scheduling fax (906) 225-4479. For urgent infusion services needs after normal hours and on the weekends, please contact the Emergency Department at (906) 225-3561.
Once you have submitted the completed form, please contact the Central Scheduling office at (906) 225-3551 to schedule the patient. During this phone call, we will review the order to ensure everything has been completed including the following:
- Patient's full name and date of birth
- Patient contact information
- Current insurance information/prior authorization, if applicable
- Written order (required) on Infusion Center Order Forms
- Valid diagnosis code
- Current history and physical
- Any recent labs/tests, if applicable
For patient information regarding infusion medications, click here to access PubMed Health.
Infusion Center Order Forms: