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Authorization Manager
To use this tool, simply log in, click on this page in the eTools tab, and look for the Go Now button. No additional username or password is necessary. Not registered for Provider Central? Find out who can register.
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Key features

The Authorization Manager tool allows you to:

  • Search member-specific authorization requirements by code
  • Submit authorization requests for behavioral health, medical, and surgical services that require authorization (does not include oral surgery services)
  • Receive automatic authorization for hip, knee, spine, or hysterectomy surgery if InterQual criteria are met and the member’s eligibility is active
  • Verify referrals
  • View the status of authorization requests for all Blue Cross Blue Shield of Massachusetts members.* Includes:
    • Requests for commercial, indemnity, Federal Employee Program, Medex® and Medicare Advantage members
    • Requests submitted via phone, fax, Online Services, and vendors such as AIM Specialty Health and WholeHealth Networks (Tivity)
  • Upload documentation to support clinical review
  • Search by provider number to look up multiple patients at the same time

* 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.

Important information
  • If authorization is not required, the system will not allow you to submit a request through Authorization Manager.
  • Prefixes. When submitting authorization requests:
    • You don’t need the three letter prefix for most Blue Cross members.
    • You do need the “R” for FEP members.
  • You also may search for patient eligibility by clicking on the “Request Medical PA” option.

  • Note about twins. At this time, Authorization Manager will not return eligibility if the patient is a twin. While we work to correct this issue, please fax your request or call us.
  • Member eligibility error message.
    If you try to access patient eligibility through the “Eligibility Search” feature, you may see an error message. The error is displaying incorrectly. This is a temporary issue we are working to resolve. If you see this message, click the blue “OK” button and accurate search results will appear.  You also may search for patient eligibility by clicking on the “Request Medical PA” option under Prior Authorization where your search results will display without an error message. We apologize for any inconvenience to you.
  • Authorization Manager does not impact Online Services referral and authorization submissions or inquiries.
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
1-888–282–1315
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