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Hospitalization or Pre-Admission Review (PAR)

For dates of service on or after October 1, 2015, use
ICD-10 codes when submitting a Pre-Admission Review.


A Pre-Admission Review is the process of notifying Blue Cross Blue Shield of Wyoming (BCBSWY) of an inpatient stay. The participating provider or participant must notify BCBSWY of ALL inpatient stays. When a patient is transferred from one facility to another, the provider of the receiving facility should notify BCBSWY. Our policies begin with the following prefixes: ZSA, ZSC, ZSD, ZSE, ZSF, ZSH, ZSK, ZSM, ZSP, and R. For all other prefixes, please call 1-800-676-2583 to find the Blue Cross Blue Shield Plan you will need to contact for pre-admission review.

When to Call BCBSWY:

A provider should call BCBSWY when:

  • A patient is being scheduled for an inpatient stay
  • A patient is being admitted for an inpatient stay
  • A patient is a FEP member and is in an observation status greater than 48 hours
  • A patient is in an observation status and their contract number begins with the following prefixes
    • ZSA, ZSP

Please note that our staff may indicate that an authorization
is not necessary for members with these prefixes as it may
or may not be required based on their contract.

A provider does not need to call BCBSWY when:

  • A patient is a FEP member and is in an observation status less than 48 hours
  • A patient is in an observation status and their contract number begins with the following prefixes
  • A patient is on Medicare and has a contract number beginning with ZSM
  • A patient’s BCBSWY policy is secondary to other insurance unless benefits with the other insurance have been exhausted
To complete the Pre-Admission Review:
  • Call 1-800-251-1814, Option 3
  • Due to the high volume of calls, you may be prompted to leave a voice mail. Please include the following information in your voicemail:
    • Name of caller, caller’s facility, and caller’s phone number
    • Name of patient, patient’s date of birth, patient’s policy number
    • Date of admission
    • Admitting diagnosis including diagnosis codes
    • Admitting procedure including CPT codes
    • Physician’s name including spelling and physician’s address
    • Facility name and facility address
    • Type of stay – Outpatient, Observation, or Inpatient

Once the information is received and processed, we will call you back with an authorization number and an initially authorized length of stay. Prospective Review (pre-certification) may be required for services being performed.

Concurrent Review:

Once a patient has exhausted their initially authorized length of stay, our Utilization Review staff will follow the patient for concurrent review. BCBSWY requires notification of discharge date.

Contact Us:

Providers: Call our Utilization Review staff at 1-800-251-1814, Option 2 or
307-432-2844 with questions, concerns, or to complete an update. Fax clinical documentation to the attention of UR Staff at 307-778-8582.

Members: Call Member Services at 1-800-442-2376 with questions regarding your hospital authorization.

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