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Commercial/FEP Procedures/Services: Individual QHP ...

Prior Authorization Request (Please do not use for Pharmacy or Behavioral Health). Submission of this information by fax or phone does not constitute authorization of services. Blue Cross of Idaho's Healthcare Operations department will notify you of its decision by fax, phone or via the portal at o For services that require authorization please see our Prior Authorization Requirements Checklists. Please fax this completed form, along with the medical records documenting the clinical indications or medical necessity to the appropriate fax number listed below. For routine requests, please allow 10 business days for processing. Commercial/FEP procedures /Services: Fax 208-331-7344 Individual QHP procedures /Services: Fax 208-286-3583. Inpatient Notification: Fax 208-331-7326 Medicare Advantage procedures /Services: Fax 208-395-8204.

Services Requiring Prior Authorization Prior authorization for the following may not be required for specific employer contracts. Complete list of codes requiring prior authorization:

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