Nov. 12, 2025
We’re making changes to improve efficiencies across the utilization management authorization processes, including online provider requests for authorization and review of services for our members with Blue Cross Community Health PlansSM.
Beginning in early 2026, you’ll experience a new online process when initiating a request for prior authorization (278 transaction) for members with BCCHPSM through Availity® Essentials.
What’s changing: You’ll be able to access the new process by initiating a request the same way you do today, in the same workflow – in Availity Authorizations, select the Illinois Medicaid payer name, and your request will be automatically directed to the appropriate process. You’ll also be able to access the new process via a separate, single-sign-on path in Payer Spaces.
Why it matters: This process will help you get the information you need quickly and efficiently. It will allow you to:
- Submit authorization requests 24x7
- Include minimum necessary supporting data to confirm if authorization is required
- Receive authorization determinations and track request status in real-time
- Easily upload supporting documentation for our clinical team
- Reduce unnecessary calls, faxes and paperwork
We’re excited to share more information in the coming months. Please continue to watch News and Updates for important dates and training resources.
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. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider.
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 Blue Cross and Blue Shield of Illinois. BCBSIL makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.