Effective 10/1/24 prior authorizations using dump code J3490 can no longer be used if the requested drug is listed on the BCBSWY redirection of care (ROC) list. Prior authorizations using J3490 will be rejected, using the appropriate HCPCS code will correct this issue.
Provider Directory Validation Reminder
You can find the Provider Directory Validation guide under the Provider Resources section on the right rail of the website.
Providers can use the Directory Validation tool on the Availity Portal to find NPI and tax ID combinations.
The No Surprises Act (NSA) requires you confirm this information every 90 days.
Prior Authorization Tip
Availity Users: Here is how to use the Authorization/Referral Inquiry and the Authorization/Referral Dashboard in Availity:
- Inquiry allows users to search for any authorizations that they have submitted/edited individually
- Dashboard allows users to search for an authorization submitted by any user assigned to your organization
Updated: The BCBSWY Provider Manual Prior Authorization section was updated to reflect current review timelines. Find the new version here.
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