Precertification Information

Online Precertification

Online precertification/pre-service review is available for these services:

  • Behavioral Health
  • Cancer Treatment Pathways
  • Physician-Administered Drugs

Go to your local plan's provider portal to initiate Pre-Service Review (Electronic Provider Access) for these services for out-of-area members. Contact your local Blue Plan for more information on how to access this functionality in your local provider portal.

Radiology Precertification and Benefit Information

 

Use the forms listed at the bottom of this page for other services requiring precertification or call the appropriate toll-free number to initiate precertification for these services via telephone:

  • 1-844-594-6010 - Physical/Occupational/Speech Therapy
  • 1-855-288-8357 - All other services (including Peer-to-Peer Consultations):

Advanced Radiology Imaging (MRI, CT, PET)

Chiropractic

Home Health

Hospice

Inpatient Hospital

Long-Term Acute Care

Physical/Occupational/Speech Therapy

Predetermination (Medical, Surgical, DME)

 

Title View
Chiropractic Visits Certification Form
Durable Medical Equipment Certification
Home Health Services Certification Request
Hospice Certification Request Form
Long-Term Acute Care Pre-Admission Evaluation
Occupational Therapy Precertification Request
Outpatient Predetermination Request
Physical Therapy Precertification Request
Post Service Appeal Questions & Answers
Preservice Appeal Questions & Answers
Provider Post-Service Appeal Form
Speech Therapy Precertification Request