View Reminders and Quick Tips for Medicaid Authorizations

Oct. 15, 2026

In April, we launched Medicaid Authorizations, a new application in Availity® Essentials to submit and manage utilization management requests for Illinois Medicaid members. If you haven’t yet started using this new application, or if you need a refresher, we encourage you to review the tips and reminders below. 

Why use Medicaid Authorizations?
Through Medicaid Authorizations, you can check in real time if prior authorization or notification is required for Medicaid members. If prior authorization is required for requests handled by Blue Cross and Blue Shield of Illinois, you'll move directly into the request submission process. You’ll be able to submit concurrent reviews, attach medical documentation and view letters online.

How to gain access 
There are two ways to access Medicaid Authorizations: 

  • Through Availity Authorizations & Referrals – Begin a request as you normally would in Availity by selecting Authorization Request. Be sure to select the correct payer for Blue Cross Community Health PlansSM. Watch the alert messages at the top of the screen in Availity for instructions.
  • Through Availity Payer Spaces – Select Applications, then Medicaid Authorizations Portal.

You’ll be transferred into the Medicaid Authorizations application in a new tab.

Navigating your request
The Medicaid Authorizations application is set up to guide you through what’s needed. Here are some navigational tips:

  • Select the correct payer, as noted above.
  • Find the member – After selecting inpatient or outpatient, search for the member, watch for the member result and active eligibility. Once you select these attributes, you’ll be able to build your request.
  • Conduct a quick search to enter your provider information – Select the search attribute (e.g., provider name, National Provider Identifier or Tax ID), start typing in the search bar and press enter to select the option to populate. (This method is best to help narrow your search, rather than selecting the magnifying glass, which returns more information.)
  • Select the diagnosis or procedure code – Both the code and description for diagnosis and procedure are required for many authorization submissions. If you search and select the code, the description will automatically populate for you. If there isn’t a red asterisk next to the field, filling it out is optional.
  • Save drafts to complete later – Need more time? You can start a new request and save it to complete later. Draft authorizations are available until the end of the day.

Other educational resources
Refer to Availity Authorizations & Referrals for more information, including a link to our Medicaid Authorization Portal user guide. The user guide has additional submission tips, reminders and contacts for further education and support if needed.

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.

The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.

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.