Availity's Authorizations tool (HIPAA-standard 278 transaction) allows providers to electronically submit prior authorizations for inpatient admissions and select outpatient services handled by BCBSMT. Additionally, providers can also check status on previously submitted requests and/or update applicable existing requests.
Benefits of using this online functionality:
- No separate user enrollment needed
- Direct access within Availity Essentials
- Simplified four step process
How to access and use Availity Authorizations:
- Log in to Availity
- Select Patient Registration menu option, choose Authorizations & Referrals, then Authorization Request
- Select Payer BCBSMT, then choose your organization
- Select a Request Type and start request
- Review and submit your request
For additional details, refer to the Availity Authorizations User Guide.
Important Tips:
- Check eligibility and benefits online first to determine if prior authorization is required for the service and/or procedure code(s). To learn more about checking eligibility and benefits via Availity, refer to the Eligibility and Benefits User Guide.
- Authorizations managed by Carelon Medical Benefits Management (formerly known as AIM Specialty Health) are handled through the Carelon Medical Benefits Management provider portal.
- Authorizations managed by eviCore healthcare (eviCore) are handled through the eviCore portal.
- For Recommended Clinical Review requests:
- Submit via Availity Attachments tool by completing and uploading the appropriate form. Learn how to submit electronically by referring to the Availity Attachments: Submit Recommended Clinical Review Requests page.
- You can also use BlueApprovR via single sign-on access from Availity to submit recommended clinical review (RCR) requests for some inpatient and/or outpatient, medical and surgical and specialty pharmacy drugs for many BCBSMT commercial members.
- If you do not have Availity access, you may fax or mail the appropriate form in the Forms and Documents section.
Providers who are not yet registered with Availity, can sign up today at Availity, at no charge. If you need registration assistance, contact Availity Client Services at 800-282-4548.
Questions?
Email our Provider Education Consultants. Be sure to include your name, direct contact information, Tax ID and/or Billing NPI.
Checking eligibility and/or benefit information 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 applicable on the date services were rendered. If you have any questions, please 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 BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.
eviCore is an independent specialty medical benefits management company that provides utilization management services for BCBSMT. eviCore is wholly responsible for its own products and services. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.
Carelon Medical Benefits Management (formerly known as AIM Specialty Health) is an independent medical benefits management company that provides utilization management services for BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.