bcbs prior authorization phone number for Providers

If you're a healthcare provider looking to get prior authorization from BCBS, you'll want to know their phone number for providers.

The BCBS prior authorization phone number for providers is 1-800-676-2583.

This phone number is specifically for providers, not patients, and is available Monday through Friday, 8am to 5pm.

You can also submit prior authorization requests online through the BCBS provider portal.

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Blue Shield of California has a dedicated team for managing medical care, including prior authorization. They can be reached at Blue Shield Medical Care Solutions, P.O. Box 629005, El Dorado Hills, CA 95762-9005.

If you're a Blue Shield member, you can contact their Care Management Response Line/Transplant Line for questions about prior authorization, case management, and other medical issues. The phone number is (800) 637-2066 ext. 3507708.

For Medi-Cal members, Blue Shield Promise has a separate contact line, but unfortunately, the phone number is not provided in the article section. However, you can try sending them an email or finding their contact information through their service area.

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If you're a provider looking for information on how to work with Blue Shield of California, you're in the right place. Blue Shield of California has a dedicated Provider Services department that can help with various questions and needs.

You can contact Blue Shield of California's Mental Health Service Administrator at (877) 263-9952, 24 hours a day, seven days a week, for authorization for transfer or post-stabilization care for mental health services.

Blue Shield of California has multiple phone numbers for different services, including (800) 541-6652 (Option 6) for general questions, (800) 633-4581 (Option 6) for Blue Shield 65 Plus (HMO), and (800) 468-9935 for questions related to Blue Shield Promise medical or pharmacy authorizations.

If you're a BlueCard provider, you can contact BlueCard provider customer services for more information.

Here are some key contact numbers to keep handy:

You can also contact Blue Shield of California's Medical Care Solutions team at P.O. Box 629005, El Dorado Hills, CA 95762-9005, or call the Care Management Response Line/Transplant Line at (800) 637-2066 ext. 3507708 for HMO and PPO services.

Dental prior authorization is a process required for specified dental procedures before they are performed.

The dental or healthcare provider will typically obtain this preauthorization for the insured member, but it is the provider's responsibility to ensure the preauthorization is obtained before the services are performed.

Services that are not preauthorized when required are not payable by USAble Mutual Insurance Company and will be the insured's responsibility.

If you need to submit a dental prior authorization request, you can contact the provider's office to initiate the process.

Keep in mind that the specific requirements for dental prior authorization may vary depending on the insurance plan and provider.

To ensure a smooth process, it's essential to verify the prior authorization requirements with the insurance company or provider before scheduling the dental procedure.

Here are some general steps to follow:

By following these steps and verifying the prior authorization requirements, you can ensure that your dental procedure is covered by your insurance plan.

Prior authorization is a process required for specified dental procedures, medical services, and pharmacy benefits before they are performed or dispensed. This includes procedures like Human Growth Hormone and Immunoglobulin Therapy, which require prior authorization.

The provider or healthcare professional must obtain preauthorization for the insured member, and it's their responsibility to ensure the preauthorization is obtained before services are performed. Services that are not preauthorized when required are not payable by the insurance company and will be the insured's responsibility.

To obtain prior authorization, you can review the criteria and fax or email a completed prior authorization form. For pharmacy benefits, you can complete the prior authorization form through CoverMyMeds for most drugs. For specific pharmacy medical policies, use the links below:

Some procedures, like Germline Genetic Testing for Hereditary Breast/Ovarian Cancer Syndrome and Other High-Risk Cancers (BRCA1, BRCA2, PALB2), require prior authorization due to their high cost. You can find the list of high-cost drugs and therapies that require prior authorization on the insurance company's website.

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Preauthorization determines whether the proposed service or treatment meets the definition of medical necessity under the applicable benefit plan. However, preauthorization is not a guarantee of payment of benefits, and payment is subject to several factors, including eligibility at the time of service and payment of premiums/contributions.

You can find the lists of procedure codes that require prior authorization on the insurance company's website, including the 2022 Procedure Code Lists Effective 01/01/2022 and 04/01/2022. These lists are not exhaustive, and the presence of codes on these lists does not necessarily indicate coverage under the member benefits contract.

On a similar theme: Bcbs Denial Codes List

To initiate the prior authorization process, you'll typically need to call the BCBS prior authorization phone number within 24 to 72 hours of receiving the request.

The timeframe for receiving a response from BCBS varies, but most requests are processed within 2-5 business days.

The specific requirements for prior authorization can vary depending on the type of service or treatment being requested.