Blue Cross Community OptionsSM: Benefit Preauthorization Process for Rule 132 Services

Posted July 13, 2017

Effective May 19, 2017, Blue Cross and Blue Shield of Illinois (BCBSIL) enhanced the benefit preauthorization process for Rule 132 Services that are requested for our Blue Cross Community Options members.

All benefit preauthorization requests for the following Rule 132 Services – Assertive Community Treatment, Community Support Team, Community Support Residential and Psychosocial Rehabilitation – should be submitted to BCBSIL using the Rule 132 Service Request Form, which is available in the Education and Reference Center/Forms section

If you have any questions regarding this information, please reach out to your assigned BCBSIL Provider Network Consultant. Thank you for your cooperation as we work to optimize the benefit preauthorization process to better serve you and our members.

Please note that the fact that a service has been preauthorized/pre-certified 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 applicable on the date services were rendered.