Anthem Blue Cross and Blue Shield (Anthem) recommends submitting precertification requests via Interactive Care Reviewer (ICR), a secure utilization management tool available in Availity. ICR offers a fast, efficient way to securely submit your requests with clinical documentation. You can also check status of an existing request and auto-authorize more than 40 common procedures. Providers are
responsible for verifying precertification requirements before services are rendered. You can use the Precertification Lookup Tool or reference the provider manual to determine if authorization is needed. We encourage providers to use ICR in Availity for all notifications or precertification requests, including reporting a member’s pregnancy. Need help with Availity?Precertification contactsPharmacyPrescription drugs, including specialty medications, some over-the-counter (OTC) medications and home infusion therapy solutions, are covered by ForwardHealth. ForwardHealth Provider ServicesPhone:800-947-9627 Website:www.forwardhealth.wi.gov Provider 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.
CaliforniaProvider CommunicationsUpdated prior authorization form for providersDec 1, 2018 • State & Federal / Medi-Cal Managed Care As of October 1, 2018 you should be utilizing the new Anthem Blue Cross (Anthem) prior authorization form for Medi‑Cal Managed Care and L.A. Care members. You will be happy to know that we have added additional requirements to make it easier for you when submitting prior authorization requests. This will help in a faster turn-around-time and will help us in servicing you better. Additional requirements added include:
Acquire an Anthem prior authorization form via web, phone or fax:
Featured In: © 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. 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?Need help with Availity?
Participating and Nonparticipating Durable Medical Equipment ProvidersFor durable medical equipment (DME), outpatient rehabilitation (physical therapy/occupational therapy/speech therapy), pain management, home care, home infusion or hyperbaric treatment, and wound care, please fax to 1-866-920-8362. Please fax to:Fax:1-866-920-8362 All Other Precertification Requests (Including Elective Inpatient or Outpatient Services) use the following: Fax:1-800-964-3627 Phone:1-844-396-2330 Behavioral healthServices billed with the following revenue codes always
require prior authorization: The following always require precertification: Provider tools & resources
Interested in becoming a provider in our network?We look forward to working with you to provide quality services to our members. 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.
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.. 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 long does it take Anthem to approve medication?After you ask and we get all of the information we need for medical services and items, we will notify you of our determination no later than 14 calendar days. If your request is for a Medicare Part B prescription drug, we will give you a decision no more than 72 hours after we receive your request.
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Anthem blue cross fax number for prior authorization
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