Obtain Advance Authorization for Certain Procedures

Your doctor may order sophisticated and expensive diagnostic procedures to detect serious medical conditions such as cancer, heart disease and brain disorders. Examples of such procedures are Positron Emission Tomography (PET) scan, Magnetic Resonance Imaging (MRI) and Computed Axial Tomography (CT) scan.

Sometimes these procedures may not be considered "medically necessary" or there may be an equally effective test available at a lower cost. In this event, the cost for the more expensive procedure will not covered by your medical plan benefits.

If your doctor orders a diagnostic procedure for you or a covered family member, you and/or your doctor are encouraged to obtain advance authorization from Blue Cross and Blue Shield of Illinois (BCBSIL).

To obtain advance authorization, contact BCBSIL customer service toll-free at the number on the back of your BCBSIL ID card. Be prepared to provide the following information during the call:

• Name and subscriber number
• Type of requested service
• Diagnosis (additional medical information including medical records may be requested to make the determination)
• Planned date of service

Failure to obtain advance authorization may result in reduced benefits and you could be responsible for significantly higher out-of-pocket expenses.