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Prior Notification


BCBS IL Pre-Auth Changes for 2018

Some pretty major changes to pre-auth requirements for BCBSIL.  This means that authorization staff will have to submit every time for approval.  Please keep in mind how this will impact booking timelines.


Notable changes:


19318 - Breast Reduction - Best practice has been to submit for pre-determination regardless so not a massive impact here.


211XX - CMF - Many craniomaxillofacial midface reconstruction codes now require authorization, which will be a bit of a change.  Given most of these cases may be rendered in emergency situations, hopefully not a huge process change for most of us.


30520 - Septoplasy - probably the most notable change as no review was previously required.  This will push back booking time frames for septorhinos.  For those practices booking prior to obtaining authorization please be sure to keep a close eye on this change.


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