Prior Authorization

General Prior Authorization

Need to request a prior authorization but don't know where to start? We've put together some information to better serve you when requesting precertification. Our goal is to make the precertification process fast, easy and accurate.

The Medical Form Resource Center (MFRC) is an online tool created to allow you to submit your precertification requests for some services electronically. The system is fast and easy to use and ensures accuracy. Access the user guide here. 

Precertification and Referral Guide - Learn how to submit a referral or precertification request through My Insurance ManagerSM and determine which services we can automatically authorize. 

You can also submit requests using the Prior Authorization for Services/Procedures Form.

Ancillary Services – BlueChoice HealthPlan directly manages prior authorizations, claims and network management processes for ancillary services, including:
•    Durable Medical Equipment (DME) 
•    Hemophilia management 
•    Home health services 
•    Home infusion therapy 
•    Orthotics and prosthetics 
•    Oxygen and respiratory equipment 
•    Home physical therapy 
•    Home occupational therapy 
•    Home speech therapy 
•    Private duty nursing 
•    Hospice 

Please use the Prior Authorization Request for Ancillary Services Form.