FEP Blue Focus Prior Authorization Reminder

Sep. 30, 2019

Thank you for serving our Federal Employee Program® (FEP) Blue Focus members. As a reminder, prior authorization is required for some services for FEP Blue Focus members. The services include high tech imaging studies, such as magnetic resonance imaging (MRI), magnetic resonance angiography (MRA), computed tomography (CT), computed tomography angiography (CTA), nuclear cardiology and position emission tomography (PET) scans.

For information on FEP Medical Policies and Utilization Management Guidelines, please refer to the Policies & Guidelines section.

We encourage you to check eligibility and benefits for FEP members via an electronic 270 transaction through the Availity® Provider Portal or your preferred vendor portal. If you have any questions, call the number on the member’s ID card.

Blue Cross and Blue Shield of Montana is proud of our long history of serving federal employees, retirees and their families with products that deliver high-quality, comprehensive coverage. We appreciate your continued partnership in serving your patients and our FEP members.

Checking eligibility and benefits and/or obtaining benefit prior authorization/pre-notification or predetermination of benefits is not a guarantee that benefits will be paid. Payment is subject to several factors, including, but not limited to, eligibility at the time of service, payment of premiums/contributions, amounts allowable for services, supporting medical documentation, and other terms, conditions, limitations and exclusions set forth in your patient’s policy certificate and/or benefits booklet and/or summary plan description. Regardless of any benefit determination, the final decision regarding any treatment or service is between you and your patient. If you have any questions, please call the number on the member’s BCBSMT 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 any products or services offered by third party vendors such as Availity. If you have any questions about the products or services offered by such vendors, you should contact the vendor(s) directly.