Blue Shield providers can submit medical and pharmacy authorizations online in AuthAccel. Blue Shield Promise providers can submit medical authorizations online, but pharmacy requests must faxed. Show
The status of all medical and pharmacy requests can be viewed in AuthAccel for both Blue Shield and Blue Shield Promise members, regardless of how they are submitted. Below are instructions for using AuthAccel. Request a medical authorization (PDF, 329 KB) View medical authorization status (PDF, 272 KB) Request a pharmacy authorization (PDF, 251 KB) View pharmacy authorization request (PDF, 177 KB) AuthAccel frequently asked questions (PDF, 277 KB) Prior authorization requirements for out-of-area Blue Plan membersFind medical policy and general prior authorization requirements for your patients who are covered by an out-of-area Blue Plan. Find requirements © 2005 - 2022 copyright of Anthem Insurance Companies, Inc. Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., © 2022 ©2022 Empire © 2005 - 2022 copyright of Anthem Insurance Companies, Inc. Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., © 2022 ©2022 Empire © 2021 Anthem Insurance Companies, Inc. Anthem Blue Cross is the trade name of Blue Cross of California and Anthem Blue Cross Partnership Plan is the trade name of Blue Cross of California Partnership Plan, Inc. Independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. Anthem Blue Cross (Anthem) is available by fax or Interactive Care Reviewer (ICR) 24/7 to accept prior authorization requests. Our Interactive Care Reviewer (ICR) tool via Availity is the preferred method for submitting prior authorization requests, offering a streamlined and efficient experience for providers requesting inpatient and outpatient medical or behavioral health services for our members. Additionally, providers can use this tool to make inquiries on
previously submitted requests, regardless of how they were sent (phone, fax, ICR or another online tool). To request or check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer (ICR) tool via Availity. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate. Don’t have an Availity account?Prior Authorization Contact InformationProviders and staff can also contact Anthem for help with prior authorization via the following methods: Utilization Management (UM) for Medi-Cal Managed Care (Medi-Cal)
Utilization Management (UM) for Major Risk Medical Insurance Program (MRMIP)
Anthem Blue Cross Cal MediConnect Plan
PharmacyPharmacy Prior Authorization Center for Medi-Cal:
*For Medicare-Medicaid Plan pharmacy requests, please contact Anthem Blue Cross Cal MediConnect Plan (Medicare-Medicaid Plan) Customer Care at 855-817-5786. Services requiring prior authorizationAnthem’s Prior Authorization Lookup Tool Online can assist with determining a code’s prior authorization requirements. You can also refer to the provider manual for information about services that require prior authorization.
Emergency medical servicesAnthem does not require prior authorization for treatment of emergency medical conditions. In the event of an emergency, members may access emergency services 24/7. In the event that the emergency room visit results in the member’s admission to the hospital, providers must contact Anthem within one business day following admission or post-stabilization. Anthem is available via the Interactive Care Reviewer (ICR) in Availity 24/7 to accept emergent admission notification. Related ResourcesProvider tools & resources
Interested in becoming a provider in the Anthem network?We look forward to working with you to provide quality services to our members. What form do providers in California use to request prior authorization?Providers must request CCS services using a SAR form. Note: Providers should verify CCS eligibility before submitting a SAR. Providers are required to submit documentation to substantiate medical necessity at the time the SAR is submitted.
How do I submit a prior authorization to availity?How to access and use Availity Authorizations:. Log in to Availity.. Select Patient Registration menu option, choose Authorizations & Referrals, then Authorizations*. Select Payer BCBSOK, then choose your organization.. Select a Request Type and start request.. Review and submit your request.. How do I contact Anthem Blue Cross California provider number?By Phone: Call the number on the back of the member's ID card or dial 800-676-BLUE (2583) to speak to a Provider Service representative.
What is the fax number for Anthem Blue Cross of California?Phone: Call 1‑888‑831‑2246, option 3 and ask for a form to be faxed to you. Fax: Send your request to: 1-800-754-4708. Anthem Blue Cross is the trade name of Blue Cross of California.
|
Anthem blue cross of california prior authorization form
Related Posts
Copyright © 2024 membukakan Inc.
