Prior authorization requirements
To request or check the status of a prior authorization request or decision for a particular Healthy Blue member, access our Interactive Care Reviewer (ICR) tool via Availity. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate.
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Behavioral health
Services billed with the following revenue codes always require prior authorization:
- 0240–0249 — All-inclusive ancillary psychiatric
- 0901, 0905 to 0907, 0913, 0917 — Behavioral health treatment services
- 0944 to 0945 — Other therapeutic services
- 0961 — Psychiatric professional fees
Fax all requests for services that require prior authorization to:
- 1-877-434-7578 (Inpatient)
- 1-800-505-1193 (Outpatient)
Pharmacy
Check out our Preferred Drug List .
Services billed with the following revenue codes always require prior authorization:
- 0632 — Pharmacy multiple sources