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Blueadvantage ppo sm services authorization request

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BlueAdvantage (PPO)SM Services Authorization Request

www.bcbst.com

BlueAdvantage (PPO)SM Services Authorization Request Please type/print legibly. Upon completion of this form, please fax to 1-888-535-5243. For a faster response submit online DRG authorization requests via BlueAccess

  Services, Request, Authorization, Blueadvantage, Sm services authorization request

Total Healthcare Management, Utilization Management and ...

www.bcbst.com

• Reconsideration (when services are still active) – Provide additional information via web/phone/fax. • Peer-to-Peer (two dates and times required)

  Services, Management, Utilization, Utilization management

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