Providers

Prior authorization requirements

To request or check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer tool via Availity. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate.


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Behavioral health

Fax all requests for services that require prior authorization to 877-664-1499.

Services billed with the following revenue codes ALWAYS require prior authorization:

    0240-0249
  • All-inclusive ancillary psychiatric
  • 0901
  • Behavioral health treatment services
  • 0905-0907
  • Behavioral health treatment services
  • 0913
  • Behavioral health treatment services
  • 0917
  • Behavioral health treatment services
  • 0944-0945
  • Other therapeutic services
  • 0961
  • Psychiatric professional fees

Pharmacy

Check our Preferred Drug List

Services billed with the following revenue codes ALWAYS require prior authorization:

    0632
  • Pharmacy multiple sources

Provider Tools & Resources

Interested in becoming a provider in the Healthy Blue network?

We look forward to working with you to provide quality services to our members.