Quick Answer: How Long Does Prior Authorization Take Blue Cross Blue Shield?

How long does it take for a prior authorization to be approved?

Typically within 5-10 business days of hearing from your doctor, your health insurance company will either approve or deny the prior authorization request.

If it’s rejected, you or your doctor can ask for a review of the decision..

How can I speed up my prior authorization?

16 Tips That Speed Up The Prior Authorization ProcessCreate a master list of procedures that require authorizations.Document denial reasons.Sign up for payor newsletters.Stay informed of changing industry standards.Designate prior authorization responsibilities to the same staff member(s).More items…

Who is responsible for prior authorization?

4) Who is responsible for getting the authorization? In most cases, the doctor’s office or hospital where the prescription, test, or treatment was ordered is responsible for managing the paperwork that provides insurers with the clinical information they need.

Does PPO require prior authorization?

Prior authorization is a way for a PPO to make sure it’s only paying for healthcare services that are really necessary, so the insurers might require you to get pre-authorization before you have expensive tests, procedures, or treatments.

What information is needed for prior authorization?

Here is a sample prior authorization request form. Identifying information for the member/patient such as: Name, gender, date of birth, address, health insurance ID number and other contact information.

How do I check prior authorization status?

1. Click Medical Authorization Status or Pharmacy Authorization Status directly from the home page or from the left navigation pane on the blue Authorizations tab located underneath the Blue Shield logo. 2. Select the Tax ID Number from the drop-down list under which you will submit or view authorizations.

How long does it take to get Blue Cross Blue Shield insurance card?

You will most likely receive your card the first week of January. If you do not receive your member ID card in the mail within 30 days, please contact your Health Benefits Officer (HBO).

What is the prior authorization process?

Prior authorization (prior auth, or PA) is a management process used by insurance companies to determine if a prescribed product or service will be covered. … that require PAs need healthcare providers to obtain approval from the patients’ health insurance before the cost of the service is covered by the company.

Why do prior authorizations get denied?

Insurance companies can deny a request for prior authorization for reasons such as: The doctor or pharmacist didn’t complete the steps necessary. Filling the wrong paperwork or missing information such as service code or date of birth. The physician’s office neglected to contact the insurance company due to lack of …

How do I submit a prior authorization?

Prior authorization works like this:Step 1: Your pharmacy will contact if your doctor if he or she did not obtain prior authorization from the insurance company when prescribing a medication.Step 2: The physician will contact the insurance company and submit a formal authorization request.More items…•Oct 12, 2018

What services typically require prior authorizations?

The other services that typically require pre-authorization are as follows:MRI/MRAs.CT/CTA scans.PET scans.Durable Medical Equipment (DME)Medications and so on.Jan 1, 2016

What should you do with the authorization number once you have prior approval?

What should you do with the authorization number once you have prior approval? Document it in the financial record and on all forms associated with the procedure.