Phone - Call the AIM Contact Center at 866-455-8415, Monday through Friday, 6 a.m. to 6 p.m., CT; and 9 a.m. to noon, CT on weekends and holidays. In Connecticut: Anthem Health Plans, Inc. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. Enhanced Care Management (ECM) under CalAIM is a care management benefit that is community-based and provides a whole person approach to care that addresses the clinical and nonclinical needs of members with the most complex medical and social needs. On June 1, 2022, prior authorization (PA) requirements will change for a code covered by Anthem Blue Cross and Blue Shield. The notice also refers to a medical policy for more information to help clarify when and how prior authorization requirements may apply. Effective February 1, 2019, CareFirst will require ordering physicians to request prior authorization for molecular genetic tests. This approval process is called prior authorization. BCBS FEP Vision covers frames, lenses, and eye exams. Please check your schedule of benefits for coverage information. FEP Medications requiring online prior authorization, Intravenous Immune Globulin (IVIG) Therapy, Stereotactic Radiosurgery Using Gamma Rays, Surprise Billing - Out-Of-Network Provider Notice, Ambulance -elective air transport only (10.0.005), Behavioral Health and Substance Use Disorder (Milliman Care Guidelines), Repetitive Transcranial Magnetic Stimulation (TMS), Inpatient Behavioral Health and Substance Use Disorder, Home health care (Criteria defined in the employer group benefit contract), Home Infusion Therapy (Criteria defined in the employer group benefit contract), Hospice (Criteria defined in the employer group benefit contract), Inpatient rehabilitation (Apollo Managed Care Physical Therapy, Occupational Therapy and Rehabilitation Care), Maternity Services- inpatient only, for stay greater than 48/96 hours (Criteria defined in the employer group benefit contract), Out-of-network services (Benefits available according to the member contract), Private Duty Nursing (Criteria defined in the employer group benefit contract), Skilled nursing facility admissions (Apollo Managed Care Physical Therapy, Occupational Therapy and Rehabilitation Care). The site may also contain non-Medicare related information. State & Federal / Medicare. The list below includes specific equipment, services, drugs, and procedures requiring review and/or supplemental documentation prior to . We look forward to working with you to provide quality services to our members. Commercial non-HMO prior authorization requests can be submitted to AIM in two ways. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Contracted and noncontracted providers who are unable to access Availity may call the number on the back of the members ID card. Prior authorization requirements are specific to each patients policy type and the procedure(s) being rendered. In Ohio: Community Insurance Company. CareFirst Commercial Pre-Service Review and Prior Authorization. Rx Prior Authorization. These manuals are your source for important information about our policies and procedures. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., 2022. ). In the District of Columbia and Maryland, CareFirst MedPlus and CareFirst Diversified Benefits are the business names of First Care, Inc. Forms and information about behavioral health services for your patients. Updated June 02, 2022. Visit our PharmacyInformation page for formulary information and pharmacy prior authorization forms. PPO outpatient services do not require Pre-Service Review. 0 PPO outpatient services do not require Pre-Service Review. Online - The AIM ProviderPortal is available 24x7. Call our Customer Service number, (TTY: 711). Use the Prior Authorization tool within Availity, or Contact Provider Services To submit a precertification request: Log in to Availity. Effective 01/01/2023 (includes changes effective 04/01/2023) . Mar 1, 2022 BLUE CROSS, BLUE SHIELD and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. 844-912-0938 Email: OhioMedicaidProvider@anthem.com Prior authorization resources and contact information Services Requiring Prior Authorization Inpatient prior authorization fax numbers Physical health: 877-643-0671 Behavioral health: 866-577-2184 Medicaid prior authorization: 800-964-3627 Outpatient prior authorization fax numbers Forms and information to help you request prior authorization or file an appeal. Electronic authorizations. In Ohio: Community Insurance Company. For your convenience, we've put these commonly used documents together in one place. %%EOF Home Health/Home Infusion Therapy/Hospice: 888-567-5703. Medicare with Medicaid (BlueCare Plus SM ) Medicaid (BlueCare) TennCare. The fact that a service or treatment is described in this material is not a guarantee that the service or treatment is a covered benefit and members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Anthem offers great healthcare options for federal employees and their families. These documents contain information about your benefits, network and coverage. ICR in Availityfor all notifications or prior authorization requests, including reporting a members pregnancy. These documents contain information about upcoming code edits. Contact 866-773-2884 for authorization regarding treatment. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. This step will help you determine if prior authorization may be required for a specific member and service. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. 2005 - 2022 copyright of Anthem Insurance Companies, Inc. Medicare Advantage. PA requirements are available to contracted providers on the provider websiteat Medicare Advantage Providers | Anthem.com > Login or by accessing Availity. The clinical editing rationale supporting this database is provided here to assist you in understanding the Effective February 1, 2019, CareFirst will require ordering physicians to request prior authorization for molecular genetic tests. In Maine: Anthem Health Plans of Maine, Inc. The aforementioned legal entities, CareFirst BlueChoice, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association. CareFirst reserves the right to change this list at any time without notice. Drug list/Formulary inclusion does not infer a drug is a covered benefit. 2021 Commercial Specialty Pharmacy Prior Authorization Drug List This list was updated with 14 new codes effective Jan. 1, 2021. Do not sell or share my personal information. CareFirst does not guarantee that this list is complete or current. Prior Authorization (Nonpharmacy) Provider Correspondence Forms. Anthem Blue Cross (Anthem) is available by fax or Interactive Care Reviewer (ICR) 24/7 to accept prior authorization requests. 711. In addition, some sites may require you to agree to their terms of use and privacy policy. Learn about the NAIC rules regarding coordination of benefits. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. HealthKeepers, Inc. recommends submitting prior authorization requests for Anthem HealthKeepers Plus members via Interactive Care Reviewer (ICR), a secure Utilization Management tool available in Availity. Commercial Prior Authorization Summary and Code Lists ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. Federal and state law, as well as state contract language and Centers for Medicare & Medicaid Services (CMS) guidelines, including definitions and specific contract provisions/exclusions take precedence over these precertification rules and must be considered first when determining coverage. Healthcare Effectiveness Data and Information Set (HEDIS), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Anthem HealthKeepers Plus Provider Manual, Long-term Services and Supports Authorization Guide. Administrative. Decide on what kind of signature to create. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Plans for federal employees, retirees, retired uniformed service members, and active duty family members. Any drugs, services, treatment, or supplies that the CareFirst medical staff determines, with appropriate consultation, to be experimental, investigational or unproven are not covered services. BlueCross BlueShield of Tennessee is a Qualified Health Plan issuer in the Health Insurance Marketplace. A prior approval is required for the procedures listed below for both the FEP Standard and Basic Option plan and the FEP Blue Focus plan. Or The services marked with an asterisk (*) only require Pre-Service Review for members enrolled in BlueChoice products if performed in an outpatient setting that is on the campus of a hospital. Anthem Blue Cross and Blue Shield (Anthem) recommends submitting precertification requests via Interactive Care Reviewer (ICR), a secure utilization management tool available in Availity. The purpose of this communication is the solicitation of insurance. HealthKeepers, Inc. recommends submitting prior authorization requests for Anthem HealthKeepers Plus members via Interactive Care Reviewer (ICR), a secure Utilization Management tool available in Availity. You can also check status of an existing request and auto-authorize more than 40 common procedures. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, 2021 Commercial Prior Authorization Requirements Summary, 2021 Commercial Outpatient Medical Surgical Prior Authorization Code List, 2021 Commercial Specialty Pharmacy Prior Authorization Drug List, 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List, New Prior Authorization Requirements for Some Custom Account Members Will Take Effect Jan. 1, 2021, 2021 Medicaid Prior Authorization Requirements Summary, 2021 Medicaid Prior Authorization Code List, 2021 MA PPO Prior Authorization Requirements Summary, 2021 MA PPO Prior Authorization Code List, BCBSIL Provider Network Consultant (PNC) team, Update: Utilization Management Change for Advocate Aurora Health Members, Effective Jan. 1, 2021 This News and Updates was posted Dec.15, 2020, and updated Dec. 31, 2020 to reflect a corrected phone number. In Indiana: Anthem Insurance Companies, Inc. Providers should call the prior authorization number on the back of the member ID card. %PDF-1.6 % Details about new programs and changes to our procedures and guidelines. CareFirst of Maryland, Inc. and The Dental Network, Inc. underwrite products in Maryland only. Code Bundling Rationale 2017 Q3 CPT Codes, Code Bundling Rationale 2017 Q2CPT Codes, Code Bundling Rationale 2017 Q1CPT Codes, Code Bundling Rationale 2016 Q4CPT Codes, Code Bundling Rationale 2016 Q3CPT Codes, Code Bundling Rationale 2016 Q2CPT Codes, Code Bundling Rationale 2016 Q1CPT Codes, Code Bundling Rationale 2015 Q4CPT Codes, Code Bundling Rationale 2015 Q3CPT Codes, Code Bundling Rationale 2015 Q2CPT Codes, Code Bundling Rationale 2015 Q1CPT Codes, Code Bundling Rationale 2014 Q4CPT Codes, Code Bundling Rationale 2014 Q3CPT Codes, Code Bundling Rationale 2014 Q2CPT Codes, Code Bundling Rationale 2014 Q1CPT Codes, Code Bundling Rationale 2013 Q4CPT Codes, Code Bundling Rationale 2013 Q3CPT Codes, Code Bundling Rationale 2013 Q2CPT Codes, Code Bundling Rationale 2013 Q1CPT Codes, Code Bundling Rationale 2012 Q4CPT Codes, Code Bundling Rationale 2012 Q3CPT Codes, Code Bundling Rationale 2012 Q2CPT Codes, Code Bundling Rationale 2012 Q1CPT Codes, Code Bundling Rationale 2011 Q4CPT Codes, Code Bundling Rationale 2011 Q3CPT Codes, Code Bundling Rationale 2011 Q2CPT Codes, Code Bundling Rationale 2011 Q1CPT Codes, Code Bundling Rationale 2010 Q4CPT Codes, Code Bundling Rationale 2010 Q3CPT Codes, Code Bundling Rationale 2010 Q2CPT Codes, Code Bundling Rationale 2010 Q1CPT Codes, 1998-document.write(new Date().getFullYear()); BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the Blue Cross Blue Shield Association. Start by choosing your patient's network listed below. Musculoskeletal (eviCore): 800-540-2406. Prior Authorization Contact Information Providers and staff can also contact Anthem for help with prior authorization via the following methods: Utilization Management (UM) for Medi-Cal Managed Care (Medi-Cal) Phone: 1-888-831-2246 Hours: Monday to Friday, 8 a.m. to 5 p.m. Fax: 1-800-754-4708 National Accounts, Posts about using health Insurance and managing your health, Collections of learning resources and links to services, For Sydney Health users connect with others and find care programs. * Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield. Select Patient Registration from the top navigation. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. Use of the Anthem websites constitutes your agreement with our Terms of Use. Forms and information about behavioral health services for your patients. Please verify benefit coverage prior to rendering services. To learn more about required Colorado timelines for decisions regarding PA requests, please click, The Colorado Prescription Drug Prior Authorization Request form, The New Hampshire Prescription Drug Uniform Prior Authorization Request Form. Access the BH Provider Manuals, Rates and Resources webpage here. Select Auth/Referral Inquiry or Authorizations. These updates will be published on BCBST.com at least 30 days prior to the effective date of any additions, deletions or changes. Prior Authorization for Certain Hospital Outpatient Department (OPD) Services Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) Prior Authorization Process for Certain Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Items Review Choice Demonstration for Home Health Services Return to Top This tool does not reflect benefits coverage* nor does it include an exhaustive listing of all noncovered services (in other words, experimental procedures, cosmetic surgery, etc. Follow the step-by-step instructions below to design your anthem forms: Select the document you want to sign and click Upload. AIM Specialty Health (AIM) is an independent company that has contracted with BCBSIL to provide utilization management services for members with coverage through BCBSIL. Please reference the Blues & CDHP Products Prior Authorization List on the Prior Authorization webpage. Please note: This change is not applicable to the members enrolled in the Mercy Co-worker Plan as they have a customized prior authorization list. The following summary and related prior authorization lists were posted on the Support Materials (Commercial) page the Utilization Management section of our Provider website as of Jan. 1, 2021: Commercial Communications For your convenience, we've put these commonly used documents together in one place. Code pairs reported here are updated quarterly based on the following schedule. February 2023 Anthem Provider News - Missouri, New ID cards for Anthem Blue Cross and Blue Shield members - Missouri, Telephonic-only care allowance extended through April 11, 2023 - Missouri, January 2023 Anthem Provider News - Missouri, December 2022 Anthem Provider News - Missouri, November 2021 Anthem Provider News - Missouri. Medical Clearance Forms and Certifications of Medical Necessity. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia lingstica. Get the latest news to help improve your life and keep you healthy. Regardless of benefits, the final decision about any service or treatment is between the member and their health care provider. Prior authorization requirements and coverage may vary from standard membership and will be documented in additional information sections. Long-Term Care (LTC) Forms. In Kentucky: Anthem Health Plans of Kentucky, Inc. (Note: For changes to come later this year, refer to this notice, posted Dec. 31, 2020: New Prior Authorization Requirements for Advocate Aurora Health Members Will Take Effect April 1, 2021.). The latest edition and archives of our quarterly quality newsletter. For costs and complete details of the coverage, please contact your agent or the health plan. One option is Adobe Reader which has a built-in reader. Launch Provider Learning Hub Now Claims Overview Forms Electronic Data Interchange (EDI) Create your signature and click Ok. Press Done. The "Prior authorization list" is a list of designated medical and surgical services and select prescription Drugs that require prior authorization under the medical benefit. Bundling Rationale (Claims filed before Aug. 25, 2017). In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). In 2020, Part B step therapy may apply to some categories . 477 0 obj <>/Filter/FlateDecode/ID[<530E5E682DBDAA468541E11BFAD96BAD>]/Index[451 44]/Info 450 0 R/Length 122/Prev 255106/Root 452 0 R/Size 495/Type/XRef/W[1 3 1]>>stream The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. 2020 copyright of Anthem Insurance Companies, Inc. HealthKeepers, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. The following summaries and related prior authorization lists were posted on the Support Materials (Government Programs) page as of Jan. 1, 2021: Important Reminder: Check Eligibility and Benefits First Medicare Advantage Providers Anthem offers a variety of Medicare plans to support member needs. Prior authorization list. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. With three rich options to choose from, weve got you covered. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. View the list of services below and click on the links to access the criteria used for Pre-Service Review decisions. ICR offers a fast, efficient way to securely submit prior authorization requests with clinical documentation. Information about benefits for your patients covered by the BlueCard program. This includes our Medicaid Blue Cross Community Health PlansSM (BCCHPSM) and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM and Blue Cross Medicare Advantage (PPO)SM(MA PPO) members. CoverKids. Infusion Site of Care Prior Authorization Drug List: New Codes Will Be Added, Effective Jan. 1, 2021 This notice was posted Dec. 28, 2020, to advise you of 14 new codes being added to our specialty pharmacy prior authorization drug list. Here you'll find information on the available plans and their benefits. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), whichunderwrites or administersthe PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwritesor administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. Please check your schedule of benefits for coverage information. To get started, select the state you live in. You'll also find news and updates for all lines of business. Prior Authorization for Some Commercial Members Will Transition from eviCore to AIM, Effective Jan. 1, 2021 This notice was posted Oct. 1, 2020, to alert you of a utilization management vendor change. 451 0 obj <> endobj Here are links to some recent communications that were posted to notify you of important changes: Government Programs Prior Authorization Summary and Code Lists Effective 01/01/2022 - 09/17/2022; Prior Authorization Procedure Codes List for ASO Plans. If you have any questions, call the number on the members ID card. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. cost of services to the member if denied by Anthem for lack of medical necessity: (1) Procedures, equipment, and/or specialty infusio n drugs which have medically necessary criteria determined by Corporate Medical Policy or Adopted Clinical Guidelines. The latest edition and archives of our monthly provider newsletter. Some procedures may also receive instant approval. Providers are responsible for verifying prior authorization requirements before services are rendered. Prior Authorization Health insurance can be complicatedespecially when it comes to prior authorization (also referred to as pre-approval, pre-authorization and pre-certification). This list may vary based on account contracts and should be verified by contacting 1-866-773-2884. In the event that the emergency room visit results in the members admission to the hospital, providers must contact Anthem within one business day following admission or post-stabilization. AIM Specialty Health (AIM) is an operating subsidiary of Anthem, Inc., an independent specialty medical benefits management company that provides utilization management services for BCBSTX. Nov 1, 2021 * Once logged in to Availity at http://availity.com, select Patient Registration > Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry, as appropriate. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Large Group Prior authorization requirement changes effective June 1, 2022 Mar 1, 2022 State & Federal / Medicare On June 1, 2022, prior authorization (PA) requirements will change for a code covered by Anthem Blue Cross and Blue Shield. . Use Availity's electronic authorization tool to quickly see if a pre-authorization is required for a medical service or submit your medical pre-authorization request. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate. Prior authorization requirements and coverage may vary from standard membership and will be documented in additional information sections. Start by choosing your patient's network listed below. eviCore healthcare (eviCore) is an independent specialty medical benefits management company that provides utilization management services for BCBSIL. U.S. Department of Health & Human Services, National Association of Insurance Commissioners, Medicare Complaints, Grievances & Appeals. 494 0 obj <>stream Inpatient services and nonparticipating providers always require prior authorization. Information from Anthem for Care Providers about COVID-19 - RETIRED as of November 8, 2022. Part B Step Therapy (204 KB) Drug step therapy is a type of prior authorization that requires one drug (or drugs) to be tried for a medical condition prior to utilizing other drugs; the steps typically require lower cost drugs or drugs with better clinical outcomes to be tried first. In Connecticut: Anthem Health Plans, Inc. External link You are leaving this website/app (site). Independent licensees of the Blue Cross Association. Some drugs, and certain amounts of some drugs, require an approval before they are eligible to be covered by your benefits. Under the "Manuals" heading, click on the blue "Behavioral Health Provider Manual" text. This tool is for outpatient services only. * Services may be listed as requiring precertification (prior authorization) that may not be covered benefits for a particular member. Look up common health coverage and medical terms. Referencing the . Noncompliance with new requirements may result in denied claims. Independent licensees of the Blue Cross and Blue Shield Association. ICR offers a fast, efficient way to securely submit your requests with clinical documentation. For more information, please refer to the Medical Policy Reference Manual. Additionally, providers can use this tool to make inquiries on previously submitted requests, regardless of how they were sent (phone, fax, ICR or another online tool). Prior Authorization. You may also view the prior approval information in the Service Benefit Plan Brochures. Anthems PriorAuthorizationLookupToolOnlinecan assist with determining a codes prior authorization requirements. It clarifies a utilization management vendor change for specific members. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. endstream endobj 452 0 obj <. Medicaid Behavioral/Physical Health Coordination. Attention: If you speak any language other than English, language assistance services, free of charge, are available to you. In Virginia, CareFirst MedPlus and CareFirst Diversified Benefits are is the business names of First Care, Inc. of Maryland (used in VA by: First Care, Inc.). Sign up to receive personalized communication from us, and we'll refine it to meet your preferences. Anthem offers great healthcare options for federal employees and their families. Medical Policies and Clinical UM Guidelines, HEDIS (The Healthcare Effectiveness Data & Information Set), Early and Periodic Screening, Diagnostic and Treatment (EPSDT). 2021 Commercial Outpatient Behavioral Health Prior Authorization Code List This list is a new addition on our website for 2021. Its critical to check member eligibility and benefits through the Availity Provider Portal or your preferred vendor portal prior to every scheduled appointment. Providers should continue to verify member eligibility and benefits prior to rendering services. Choose My Signature. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. The BH prior authorization policy is outlined in the BH Provider Manual and can be accessed by following the instructions below. 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