Introducing a New Preauthorization Submission Tool via Availity® Provider Portal

Dec. 25, 2019

Blue Cross and Blue Shield of Montana (BCBSMT) is excited to introduce a brand-new online preauthorization application via the Availity Portal, called Authorizations (HIPAA-standard 278 transaction). This new and more convenient functionality will be available to providers as of Jan. 30, 2020, making it faster and easier to submit and receive confirmation from BCBSMT. For Federal Employee Program®; (FEP®), providers should continue to use their current preauthorization process until this the new application becomes available in the near future.

What does this mean?

BCBSMT’s current electronic preauthorization tool, iExchange®, will be deactivated on April 15, 2020, and all electronic preauthorization requests and referrals should be submitted using this new capability. This includes inpatient admissions, select outpatient services, behavioral health services and referral requests handled by BCBSMT.

The process of submitting preauthorization requests to eviCore is not changing.

Medical and surgical predetermination of benefits requests should be submitted via fax or mail by using the appropriate Predetermination Request Form, along with the pertinent medical documentation. This form is located in the Forms section on our Provider website.

What should you do?

During the transition period, providers should migrate from iExchange to the new five-step Availity Authorization application. Providers not yet registered with Availity can sign up today at Availity, at no charge. For registration assistance call availity.com Learn more about third-party links Client Services at 800-282-4548.

Submitting online preauthorization requests using Availity’s Authorizations application is easy and consists of only five steps:

  1. Log into availity.com Learn more about third-party links
  2. Select Patient Registration menu option, choose Authorizations & Referrals, then Authorizations*
  3. Select Payer BCBSMT, then choose your organization
  4. Select Inpatient Authorization or Outpatient Authorization
  5. Review and submit your authorization

This new online option will increase administrative efficiencies for your organization by also allowing providers to:

  • access and verify status of requests
  • upload clinical medical records
  • edit and/or extend requests
  • obtain printable confirmation number for your records

Training

BCBSMT is hosting complimentary webinars for providers to learn how to use this new online preauthorization submission application. Simply click on your preferred date and time below to register.

For More Information

Watch for the new Availity Authorizations & Referral tip sheets, coming soon to the Provider Tools section of our website.

If you need further assistance or customized training, contact our Provider Education Consultants.

iExchange is a trademark of Medecision, Inc., a separate company that provides collaborative health care management solutions for payers and providers.

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. 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 provided by third party vendors such as eviCore and Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.