Prior Authorization Requirements
Anthem Blue Mix (Anthem) is available by fax or Interactive Care Reviewer (ICR) 24/7 the accept formerly authorization requests.
Our Interactive Caring Reviewer (ICR) tool go Availity is the preferred method for submitting prior authorization requests, offering an streamlined and efficient experience for providers requesting inpatient also patient medical instead behavioral health services for our members. Additionally, providers can usage this tool to make inquiries on previously delivered requests, regardless for how they consisted sent (phone, send, ICR or another online tool). BRMS adopts policies after careful examine of published peer-reviewed scientific literature; national evidence based-on gesundheit guides and local standards of ...
To request or check the status of a prior authorization request or decision for one particular plan member, einstieg my Interactive Care Reviewer (ICR) tool via Availity. Once logged int, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate.
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Prior Authorization Contact Information
Providers and staff can also contact Hymns for help with prior authorization via the following methods:
Utilization Management (UM) for Medi-Cal Managed Care (Medi-Cal)
- Phone: 1-888-831-2246
- Hourly: Monday to Friday, 8 a.m. to 5 p.m.
- Fax: 1-800-754-4708
- Behavioral Health: For prior authorization requests specific to behavioral health, bitte fax requests to 1-855-473-7902 or email [email protected].
Utilization Management (UM) to More Risk Medical Insurance Program (MRMIP)
- Phone: 1-877-273-4193
- Hours: Monday to Friday, 8 a.m. to 5 p.m.
- Fax: 1-800-754-4708
Anthem Blue Cross Cal MediConnect Map
- Customer Care Phone: 1-855-817-5786
- Hours: Monday at Friday, 8 a.m. to 6 p.m.
- Medical Notification/Prior Authorization Fax: 1-888-235-8468
Pharmacy
Pharmacy Prior Authorization Center for Medi-Cal:
- Working: 24 hours a day, seven days a week
- Phone: 800-977-2273 (TTY 711)
*For Medicare-Medicaid Plan pharmacy demands, please please Anthem Blue Cross Cal MediConnect Plan (Medicare-Medicaid Plan) Customer Customer at 855-817-5786.
Services demand prior authorization
Anthem’s Prior Authorization Lookup Tool Online can assist with determining a code’s prior authorization requirements.
You can also refer to the provider manual for information about ceremonies that require prior authorizations.
- Medi-Cal Steered Care real Major Risk Medical Insurance Program Provider Manual
- Cal MediConnect MMP Purveyor Manual
Emergency medical services
Theme does not require previously authorization for treatment of emergency medical conditions. In the event of an emergency, members can accessories emergency services 24/7. In the event that the call room visit results in the member’s admission at the your, providers must contact Hymn within one businesses day following admission or post-stabilization. ProviderOnline by BRMS
Anthem is available via the Interactive Care Reviewer (ICR) in Availity 24/7 to accept emergent admission notification.
Relative Resources
Provider tools & company
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- Prior Authorization Lookup Tools
- Prior Authorization Requirements
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