July 5, 2023
BlueApprovR is an online tool that streamlines the prior authorization process for some medical/surgical services, pharmacy drugs and behavioral health services for many of our commercial, non-HMO members. This tool is accessible through a single-sign-on process on Availity® Essentials, so it’s easy to make it a part of your daily workflow.
Why use BlueApprovR?
Registered Availity users have free 24/7 access to BlueApprovR to:
- Secure prior authorization approvals in real-time for certain services – typically, you’ll get results in less than a minute!
- Easily attach medical records.
- Check approval status and view history.
- View all requests submitted by your organization. (This “shared access” feature is new. It was added based on feedback from existing users. We heard you!)
BlueApprovR – Types of Care
Use BlueApprovR to request prior authorization for inpatient and outpatient medical/surgical services, pharmacy drugs and behavioral health services, including these types of care:
- Specialty Pharmacy
- Behavioral Health
- Inpatient Acute Care
- Long-term Acute Care
- Inpatient Rehabilitation
- Skilled Nursing Facility
- Home Health
- Hospice and Other Outpatient Services
Join Us for a Webinar
We’d like to give you an online tour of BlueApprovR. New user? See how to access this tool and submit a request. Already using BlueApprovR? Join us for a refresher and check out what’s new. Please select your preferred date and time to sign up now for a free, instructor-led demo.
- July 6, 2023 – 10 to 11 a.m.
- July 12, 2023 – 11 a.m. to 12:30 p.m.
- July 13, 2023 – 10 to 11 a.m.
- July 19, 2023 – 11 a.m. to 12:30 p.m.
- July 20, 2023 – 10 to 11 a.m.
- July 26, 2023 – 11 a.m. to 12:30 p.m.
- July 27, 2023 – 10 to 11 a.m.
Note: You don't have to be a current Availity user to attend a webinar, but you must be registered with Availity to gain access to BlueApprovR. To become a registered user, go to Availity.com. Otherwise, you may continue to request prior authorization by calling the number on the member’s Blue Cross and Blue Shield of Illinois (BCBSIL) ID card.
Reminders and Resources
For more information, see the user guide on our BlueApprovR page. If you have any questions on accessing BlueApprovR, or if you need customized training, email our Provider Education Consultants.
Member benefits vary based on service rendered and individual and group policy elections. Always check eligibility and benefits first through Availity or your preferred web vendor, prior to rendering care and services. This step will confirm coverage and other details, such as prior authorization requirements and utilization management vendors, if applicable.
BlueApprovR is not available currently for Federal Employee Program® (FEP®), 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.