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Authorization Manager

You can now submit requests for twins and multiple birth members.
Watch our video demonstration to learn how.

If you don’t see a Go Now button, please contact the Provider Central account administrator in your office to give you access to this eTool. For more information, see our Provider Central Administrators Quick Start Guide.
To use this tool, simply log in, click on this page in the eTools tab, and look for the Go Now button. Not registered for Provider Central? Find out who can register.
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Key features

You can enter and verify referrals in Authorization Manager. Learn more about referrals.

For authorization requests, Authorization Manager offers the comprehensive feature set shown below.

Useful search tools

  • Search member-specific authorization requirements by code
  • Search by provider number to look up multiple patients at the same time

Easy request submission

  • Submit requests for mental health, medical, or surgical services (excluding oral surgery)
  • Upload documentation to support clinical review

Flexible status verification

  • View the status of requests for all Massachusetts members*
  • Check the status of requests submitted via Authorization Manager, phone, fax, and vendors such as Carelon Medical Benefits Management and WholeHealth Living, Inc., a Tivity Health Company

Automatic approvals

  • Receive automatic authorization for hip, knee, or spine surgery if InterQual criteria are met and the member’s eligibility is active

* You cannot use Authorization Manager for members who belong to a New England Blue Cross Blue Shield plan and have an out-of-state primary care provider.

Authorization Manager does not impact referral transactions in other eTools.

Tips for member searches

When entering member information:

  • Omit the ID prefix unless your patient is in the Federal Employee Program (include the "R" for FEP members).
  • Spell the member’s name exactly as it appears on their ID card.
  • If you enter a suffix (01, 02, 03, etc.) that does not result in the intended member, try another search with a different suffix.

Tips for searching by the member suffix (Commercial):

  • Subscribers will be 00
  • Spouses are 01, 02, 03 (depending on how many spouses were listed under a specific policy)
  • Dependents will start with 10 then increase as dependents are added: 11, 12, 13, etc.

Tips for searching by the member suffix (FEP):

  • FEP suffixes start at 01, not 00 like Commercial
  • Unlike Commercial, FEP suffixes do not necessarily determine the member relation (subscriber, spouse, dependent)

Reminder: Newborn babies will not appear in Authorization Manager until the subscriber adds them to their plan.

Exceptions (such as when to call or fax your request)

Please call or fax your request to us in these situations:

  • Federal Employee Program members with out-of-state plans. We need to manually enter these members into our system.
  • Any updates to an authorization, such as date of service or level of care changes.
  • These medical requests:
    • Transplants
    • Habilitation
    • Referrals to non-participating specialists/cross-border referrals. Note: non-participating and cross-border outpatient rehabilitation authorization requests may be submitted in Authorization Manager. Use "Service Request" as the request type.
    • Endovenous Laser Therapy (EVLT) status
    • Interoperative Neurological (spine) Monitoring (IONM)
    • Gene Therapy and Car-T Cell requests
    • FEP Advanced Benefit Determination
    • Individual Consideration requests (see below)
  • These behavioral health services:
    • Urine drug testing
    • Out-of-network psychotherapy

Subscribers employed by Steward Health Care

For subscribers employed by Steward Health Care, any requests for tier exceptions for them or their dependents must be submitted directly to Steward's Health Care Coordination Department.

Guides and video demonstrations

   Guides (PDFs)

Topic Guide or Quick Tip
PCP outpatient service requests
PCP outpatient specialist referrals
Medical inpatient requests
Medical services (outpatient requests)
Mental health inpatient requests
Mental health outpatient requests
Oral Surgery authorizations for Medical Members

   Video demonstrations

Topic Video
Medical services: Inpatient
Medical services: Ambulance requests
Medical services: Elective requests
Medical services: Fertility Services/Assisted Reproductive Technology (ART)
Medical services: Outpatient rehabilitation and home health care
Mental health services: Outpatient
Mental health services: Inpatient
Individual Consideration and other determinations

If you need an Organizational Determination, Advanced Benefit Determination, or Individual Consideration, please fax us at the appropriate number listed below:

For a member belonging to this plan Fax your request to:
Commercial HMO, PPO, POS, and Indemnity Fax 1-888-282-0780
Medicare Advantage HMO and PPO Fax 1-800-447-2994
Federal Employee Program (FEP) Contact your local plan. In Massachusetts, fax
Contact us
  • If you are contracted with Blue Cross Blue Shield of Massachusetts and have any questions about Authorization Manager, please contact us at hmmauthorizationmanager@bcbsma.com.
  • To contact us regarding an authorization request, please use the appropriate fax or phone number on our Prior Authorization Overview page.