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Xolair Fax Form Helps Facilitate Review Process

July 12, 2012 

In order to help support the benefit review process for Xolair requests, Blue Cross and Blue Shield of Illinois (BCBSIL) has developed a fax form to assist providers in summarizing the details needed for benefit review. 

While this new form does not replace the need for the Predetermination Request Form  and usual and necessary supporting documentation that you have normally supplied to date, we are confident that it will help facilitate the review process by limiting multiple requests for additional information. 

Please download the Xolair Preauthorization Fax Form,  which must be completed and submitted for all Xolair requests—along with the necessary supporting medical records and reports—using the fax number indicated on the form.

Responses can be expected within 14 calendar days; however, responses could take longer if the information included on the Xolair Preauthorization Fax Form is incomplete and/or the request is missing necessary supporting documentation upon submission. 

We appreciate your support in helping BCBSIL increase efficiency of the Xolair review process.