BlueApprovRSM Now Accepts Recommended Clinical Reviews for Behavioral Health – Attend a Training 

October 24, 2023

Blue Cross and Blue Shield of Illinois (BCBSIL) continues to streamline the pre-service review process to reduce your workload with BlueApprovR. This tool, accessible in Availity® Essentials, now processes optional recommended clinical reviews (RCRs) for behavioral health services, in addition to medical and surgical services, and pharmacy drugs for many of our commercial, non-HMO members.

Here’s how to submit Recommended Clinical Review and Prior Authorization Requests with BlueApprovR:

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

Note: Your RCR submissions will follow the same path through BlueApprovR as prior authorization requests. Also, your RCR submission via BlueApprovR replaces the need to fax or to attach forms in Availity. 

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. For a list of services for which recommended clinical review is available, see our Recommended Clinical Review (Predetermination) Code List.

BlueApprovR Tool Offers End-to-End Efficiencies
Registered Availity Essentials users have free, 24/7 access to BlueApprovR tool to:

  • Request prior authorization and RCRs for inpatient and outpatient behavioral health, medical and surgical services, and pharmacy drugs
  • Secure real-time approvals for certain services – begin treatment right away!
  • Easily attach medical records
  • Check approval status of your request

Provider Training
Join us this month for 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: 

You can use BlueApprovR to request prior authorization or RCR for these types of care:

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

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

Provider Resources
See our BlueApprovR page to learn more about how to access this online tool. Also continue to watch News and Updates for future program updates and training opportunities.

This tool is currently not available for Federal Employee Program® (FEP®), Medicare Advantage, Illinois Medicaid, or any of our HMO members. Please use your existing process for requesting prior authorization reviews 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 and services they offer.