Bcbs ABA Request Form Guide for Healthcare Providers

To navigate the BCBS ABA request form, it's essential to understand the requirements and guidelines set by Blue Cross Blue Shield.

The BCBS ABA request form is typically used by healthcare providers to request coverage for Applied Behavior Analysis (ABA) therapy.

According to the BCBS ABA request form, the provider must submit a detailed diagnosis of the patient's condition, including a clear description of the behavioral issues and the recommended treatment plan.

The form also requires documentation of the patient's medical history, including any previous diagnoses and treatments.

To increase the chances of approval, the provider should ensure that the form is completed accurately and thoroughly, with all necessary information included.

For another approach, see: Hipaa Records Request

To submit prior authorization requests, out-of-network providers can use the online forms available on the Blue Cross and Blue Shield of North Carolina (Blue Cross NC) website.

For best results, use the Google Chrome browser to open and complete these forms.

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You'll need to submit the Prior Authorization Form for Adaptive Behavioral Treatment for Autism to ensure authorizations are in place for January 1st.

This form is required for all commercial plans that provide a benefit as of January 1, 2022, and failure to have prior authorization in place will result in a claim denial.

Please complete this form for all members under your care and return it no later than December 21, 2021, to [email protected].

The form can be found on the Blue Cross NC website, along with other relevant forms, including the Applied Behavior Analysis (ABA) approval request form and the Behavioral Health Outpatient authorization request form.

Here are some key forms you may need to submit:

Note that Beacon Health Options and the State Health Plan have specific requirements for prior authorization, so be sure to check the Blue Cross NC website for more information.

You can use the online forms provided by Blue Cross and Blue Shield of North Carolina (Blue Cross NC) to submit prior authorization requests.

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For out-of-network providers, using the Google Chrome browser to open and complete these forms is recommended for best results.

To obtain prior authorization for Autism treatment services, you'll need to complete the Prior Authorization Form for Adaptive Behavioral Treatment for Autism.

This form must be returned to Blue Cross NC no later than December 21, 2021, for all members under your care.

The form can be returned to [email protected] along with any questions you may have.

If you're providing Applied Behavioral Analysis (ABA) services to commercial members, you can complete and return this form to assist with ensuring authorizations are in place for January 1st.

New members will require a separate request via usual authorization submission channels (fax, phone, Blue E).

Here is a list of the forms available:

If you're providing Applied Behavioral Analysis (ABA) services to commercial members, you'll need to complete the attached prior authorization form and return it to Blue Cross NC to ensure authorizations are in place for January 1st.

The form will allow Blue Cross NC to provide you with a written notification of the applicable authorization decision that will be effective January 1st.

To avoid claim denials, failure to have prior authorization in place for services rendered on or after January 1st is not acceptable.

For new members, a separate request via usual authorization submission channels (fax, phone, Blue E) will be required.

Beacon Health Options and the State Health Plan members will also require prior authorization for Autism Treatment services, and providers will need to obtain a new authorization from Blue Cross NC prior to rendering additional services.

To ensure there is an authorization in place prior to the effective date and to prevent any impact on members, the completed form should be returned to [email protected] by December 21, 2021.

The criteria form for SHP and all other new members can be found on the Request Prior Plan Approval page for submission at any time.

Here are the forms you'll need to complete: