This article is for all providers caring for our members
As a reminder, all providers will be required to submit initial authorization requests and inquiries electronically through Authorization Manager rather than by phone or fax starting June 1, 2023 for our commercial (HMO, PPO) and Federal Employee Program (FEP) members. Authorization Manager is the most efficient method to submit requests, and it’s available 24/7 at no additional cost via single sign-on through Provider Central!
Both medical and mental health providers will need to use Authorization Manager starting June 1. To help prepare you, here are some general tips:
- When entering a member’s ID number, don’t include the three-letter prefix, unless it’s a single letter “R” for FEP members.
- When entering both the Requesting Provider and Servicing Facility information, use your inpatient Provider Number when submitting inpatient requests, and outpatient Provider Number when submitting outpatient requests.
- Using the wrong Provider Number for the level of care you are requesting results in a mismatched authorization case.
Advantages of using Authorization Manager – start today!
Why wait? Start using Authorization Manager today to review authorization requirements, request authorizations, check existing case status, and view or print the decision letter. This tool also allows you to:
- Search member-specific authorization requirements by code.
- Check the status of requests regardless of how they were submitted.
- Upload additional clinical documentation to an existing case.
- Enter a transaction within minutes. By the time you call and talk to a service representative, you could have entered an authorization request!
Resources
- Authorization Manager User Guide
- Authorization Manager Provider Central page, which contains helpful tips, guides, and video demonstrations
- Authorization Manager tips for mental health providers
- Authorization Manager tips for Licensed Applied Behavior Analyst (LABA) providers
To read our News Alert announcing this upcoming mandate, log on to bluecrossma.com/provider and click News. Scroll down to the February 1 communication: “Submit referrals, authorization requests, and inquiries electronically starting June 1.”
Read our News Alert announcing this upcoming mandate: “Submit referrals, authorization requests, and inquiries electronically starting June 1.”
Questions?
We’re here to help. Please send an email to us at hmmauthorizationmanager@bcbsma.com with any questions you may have about Authorization Manager.
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