BCBS Prior Authorization

log into bcbs website click on health management in member id prefix enter first 3 letters from insurance policy number ex yps, y2u, etc click on link diagnostic and specialty care it will open in a new window once all information is entered select rehabilitation and start order request if unable to select rehab this patient's policy does not require pa for rehab select print preview and save make an alert in patient chart as well confirm patient's information and click continue condition & services enter the patient chief diagnosis code if not sure ask dr mays for back pain enter m99 03, for the service code it's cpt code 97140 for therapy type select physical therapy and save first question is this a request to provide autism services for a confirmed diagnosis of autism spectrum disorder or pervasive developmental disorder (a primary diagnosis of one of the following icd 10 codes f84 0, f84 2, f84 3, f84 5, f84 8, or f84 9)? select no was an initial evaluation performed by a therapist or a licensed qualified provider of therapy services? select yes enter the patients initial evaluation date refer to date of onset/or to soap note for functional tool, select odi oswestry low back pain disability questionnaire (0 50 points), add tool and enter score to continue ordering provider search enter clifton mays and city high point under provider results select first option check ordering provider is also the treating therapist box will the servicing facility be billing for the request? yes the office should pop up, select it and confirm it is an office, continue start clinical which of the following best describes the primary purpose of therapy? rehabilitation will any of the following be used as a primary treatment? none of these apply what is the complexity level of the evaluation or e\&m equivalent that was completed for this request? (confirm option with dr mays) moderate complexity (cpt 97162 or e\&m 99203, 99204) did the patient have a surgical procedure in the last three (3) months related to the conditions for which services are being requested? no did the onset of the injury or condition occur within the last six (6) months? yes is the requested treatment for a complex neurological, medical, or multi trauma condition? (see help text for examples) no select all conditions expected to impact treatment none of these apply attest to all of the following, hit save select unable to both patient's phone number and email to continue check preview to verify all information is correct, submit order you should get immediate results, you have to accept by selecting yes and update order complete order, and right click "print" to save in scans file as; last name, first name 'date' pa request