BlueApprovRSM Expedites Medical Surgical, Pharmacy and Behavioral Health Prior Authorization – Attend a Training 

May 30, 2023

Blue Cross and Blue Shield of Illinois continues to streamline the prior authorization process to reduce your workload with BlueApprovR. This new tool, accessible in Availity® Essentials, expedites approvals for some medical and surgical, pharmacy drugs and behavioral health services for many of our commercial, non-HMO members.

Remember: Member benefits vary based on the service being rendered and individual and group policy elections. Always check eligibility and benefits first through Availity or your preferred web vendor. This step will confirm coverage and other important details, such as prior authorization requirements and utilization management vendors, if applicable.

BlueApprovR Tool Offers End-to-End Efficiencies

Registered Availity users have free, 24/7 access to BlueApprovR to:

  • Request prior authorization for inpatient and outpatient medical surgical services, pharmacy drugs and behavioral health services
  • Secure real-time prior authorization approvals for certain services
  • Easily attach medical records
  • Check approval status and view history

Provider Training

You can attend an instructor-led, free webinar to learn how to use BlueApprovR. To register, select your preferred date and time from the list below. Times listed are Central Time.

Use BlueApprovR to request prior authorization for these types of care:

  • Specialty Pharmacy
  • Behavioral Health
  • Inpatient Acute Care
  • Long-term Acute Care
  • Inpatient Rehab
  • Skilled Nursing Facility
  • Outpatient Hospice
  • Home Health
  • Outpatient Service

How To Submit Prior Authorization Requests Through Availity

In Availity, select Payer Spaces from the navigation menu, then BCBSIL. On the BCBSIL-branded Payer Spaces page, go to the Applications tab and select BlueApprovR. You’ll be redirected to BlueApprovR to complete your request online.

Other Prior Authorization Request Methods

If you’re not a registered Availity user, register today on Availity.com. Otherwise, you may still request prior authorization by calling the number on the member’s BCBSIL ID card.

For More Information

Refer to our BlueApprovR page for a user guide and other provider resources. Continue to watch News and Updates for future program updates and training opportunities.

Note: BlueApprovR is currently not available for Federal Employee Program® or Medicare Advantage or Illinois Medicaid members. Please use your existing process for requesting prior authorization for these members.

 

Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding third party vendors and the products or services they offer.