Prior Authorization Submission
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Submitting a prior authorization through Availity is the best way to determine prior authorization requirements for a participant.
Additionally, understanding the proper Service Type makes a difference in how the prior authorizations get routed and the associated approval time.
Please view the short videos below to understand these workflows better.
High-level explanation
Follow this video to understand the basics of submitting a prior authorization.
Service Type Explanations
When submitting an authorization, you will need to select a Service Type. This routes your case to BCBSWY subject matter experts who will review and render a determination. Therefore, selecting the correct service type is key to receiving the most effective and efficient service from our authorizations team.
The videos below have additional information to help you better understand the prior authorization workflows. Choose the service type that aligns with your facility.
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Video Library: Prior Authorization Training Topics
Explore our comprehensive video library, a valuable resource providing in-depth training on various Prior Authorization topics. Access expert insights and educational content to enhance your understanding and skills in this crucial field.
This video discusses workflows of Maternity, Specialty and General, and how they are processed for prior authorizations.
In this video, we delve into MHSA workflows and how they are processed for prior authorizations.
Here, we explore Step-Down Level of Care workflows and how they are processed for prior authorizations.
This video discusses Oncology workflows and how they are processed for prior authorizations.
The content of this video entails Therapy workflows and how they are processed for prior authorizations.
Here, we take a closer look at Pharmacy and Redirection of Care workflows and how they are processed for prior authorizations.
Here, we take a closer look at the Concurrent Review submission workflow for prior authorizations.
Questions?
If you have any questions regarding prior authorizations, call +1-800-442-2376.