The most commonly requested prior authorization fax forms for procedures, injectable drugs (office administered and home self-administered) and oral/topical drugs, including templates to be used for authorization notices to Blue Shield TotalDual (HMO D …

Prior authorization forms for Blue Shield members. Download and print prior authorization forms for procedures and drugs.

Find forms you may need to submit prior authorization requests. Find medical policy and general prior authorization requirements for your patients who are covered by an out-of-area Blue Plan. A list of designated medical and surgical services and select prescription Drugs that require prior authorization under the medical benefit.

Use these lists to identify the member services that require prior authorization. Submit for medical or behavioral health inpatient or outpatient services. Tract authorization cases. Access the Authorization application from the Patient Registration tab in Availity Essentials. Availity.com. Ready to become a provider in the Anthem network?

Clinical Information Please provide all relevant clinical information to support a prior authorization review.

Use these forms to obtain prior authorization for administering medications in physician's offices and outpatient hospitals, including urgent care, hospital-based infusion care centers, and clinics where the drug is injected or infused and billed on a UB04 or CMS 1500 form.

Do you need prior authorization? Your provider must submit the prior authorization request. Find a list of services, review criteria, and more here.

Find forms you may need to submit prior authorization requests. Find forms for Blue Shield IFP, Small, Large Group and Medicare members. Find forms for Blue Shield Promise, Medi-Cal members

please visit www.myprime.com. Start saving time today by filling out this prior authorization form electronically. Visit Visit covermymeds.com to begin using this free service.

We're helping make prior authorizations faster and easier for providers and members. To begin your search, enter your Member ID and the procedure code or service description. What’s Prior Authorization? Before you get some medical treatments, your provider might have to tell your insurance company about them. This is called “prior authorization.”