April 3, 2023
Blue Cross and Blue Shield of Illinois (BCBSIL) continues to streamline the prior authorization process to reduce your workload with BlueApprovR. This new tool, accessible in Availity® Essentials, expedites approvals for some medical and surgical, pharmacy drug and behavioral health services for many of our commercial, non-HMO members.
Don’t forget! Member benefits vary based on the service being rendered and individual and group policy elections. Always check eligibility and benefits first through Availity or your preferred web vendor. This step will confirm coverage and other important details, such as prior authorization requirements and utilization management vendors, if applicable.
BlueApprovR Tool Offers End-to-End Efficiencies
Registered Availity Essentials users have free, 24/7 access to BlueApprovR tool to:
- Request prior authorization for inpatient and outpatient medical surgical services, pharmacy drug and behavioral health services
- Secure real-time approvals for certain services and begin treatment right away
- Easily attach medical records
- Check approval status of your request
Provider Training
You can attend an instructor-led, free webinar to learn how to use BlueApprovR. To register, select your preferred date and time from the list below. Times listed are Central Time:
- April 5, 2023 – 11 a.m. to noon
- April 6, 2023 – 10 to 11 a.m.
- April 12, 2023 – 11 a.m. to noon
- April 13, 2023 – 10 to 11 a.m.
- April 19, 2023 – 11a.m. to noon
- April 20, 2023 – 10 to 11 a.m.
- April 26, 2023 – 11 a.m. to noon
- April 27, 2023 – 10 to 11 a.m.
- May 3, 2023 – 11 a.m. to noon
- May 4, 2023 – 10 to 11 a.m.
- May 10, 2023 – 11 a.m. to noon
- May 11, 2023 – 10 to 11 a.m.
- May 17, 2023 – 11 a.m. to noon
- May 18, 2023 – 10 to 11 a.m.
- May 24, 2023 – 11 a.m. to noon
- May 25, 2023 – 10 to 11 a.m.
How to Submit Prior Authorization Requests through Availity Essentials
- In Availity, select Payer Spaces from the navigation menu, then BCBSIL
- On your Payer Spaces page, select the Applications tab and click BlueApprovR
- Users will be redirected to BlueApprovR to complete the request online
Other Prior Authorization Request Methods
If you’re not a registered Availity Essentials user, register today on Availity.com. Otherwise, you may still request prior authorization with BCBSIL by calling the number on the member ID card.
Note: This new tool is currently not available for Federal Employee Program® or Medicare Advantage or Illinois Medicaid members. Please use your existing process for requesting prior authorization for these members.
Provider Resources
Learn more about how to access and use BlueApprovR at our Provider Tools web page.
For More Information
Continue to watch News and Updates for future program updates and training opportunities.
Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors.