Find Bcbs Anthem Prior Authorization Phone Number and Requirements

To find the BCBS Anthem prior authorization phone number, you can check your insurance card or the BCBS Anthem website.

You can also call the BCBS Anthem customer service number at 1-800-676-5576 to ask for the prior authorization phone number.

BCBS Anthem has a dedicated team to handle prior authorization requests, which typically takes 2-3 business days to process.

Before calling the prior authorization phone number, have your patient's medical information and the prescribed medication details ready to expedite the process.

You can initiate the prior authorization process by contacting Anthem's Utilization Management staff, who will review your request to determine if the service is medically needed and covered by your Anthem HealthKeepers Plus benefits.

Anthem is available 24/7 to accept prior authorization requests via phone or the Interactive Care Reviewer (ICR) via Availity.

To get in touch with Anthem's Utilization Review team, you can also contact them through various methods, including phone, email, or the ICR.

Their team will review your request to ensure the service is medically necessary and covered by your benefits.

If your Anthem HealthKeepers Plus plan won't approve care you think you need, you can ask them to take another look. You or your provider can submit a request for reconsideration.

You can ask for a review of services that were not approved or have been limited in amount or time.

The Utilization Review team or your care manager/care coordinator can help answer any questions you have about an approval or denial.

To ask questions or request a review, call Member Services at 800-901-0020 (TTY 711).

Here are the contact methods for prior authorization:

Care and Service Choices can be complex, but understanding how they work can help you navigate the system more easily. Utilization Management, or UM, is a program that reviews what services are medically necessary.

Our UM program looks at what services are needed, when they're needed, and how much of our services are required. Some services need prior approval from your Anthem HealthKeepers Plus plan.

Services that don't need approval include routine check-ups and preventive care. These services are typically covered without needing special approval.

If your provider wants you to have a service that needs approval, they'll need to ask your Anthem HealthKeepers Plus plan for permission first. This ensures that only medically necessary services are covered.

You can reach out to Anthem's Utilization Management staff for help with prior authorization. They're available to answer your questions and assist with your requests.

The Utilization Review team reviews approval requests to determine if the service is medically needed and if it's included in your Anthem HealthKeepers Plus benefits. They consider two main things: whether the service is medically needed and if it's covered under your benefits.

If your Anthem HealthKeepers Plus plan denies a service you think you need or limits the amount or length of time for a service, you or your provider can ask them to take another look. This is called an appeal.

To appeal a denied or limited service, you can ask the Utilization Review team to review it again. They'll let you and your provider know when they receive your request. You can appeal services that weren't approved or were limited in amount or time.

If you have questions about an approval or denial, call Member Services at 800-901-0020 (TTY 711). The Utilization Review team or your care manager/care coordinator can help answer your questions.