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Anthem Blue Cross is the trade name of Blue Cross of California and Anthem Blue Cross Partnership Plan is the trade name of Blue Cross of California Partnership Plan, Inc. Independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County.
To request or check the status of a prior authorization request or decision for a particular plan 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 precertification:
0240–0249 | All-inclusive ancillary psychiatric |
0901, 0905–0907, 0913 and 0917 | Behavioral health treatment services |
0944–0945 | Other therapeutic services |
0961 | Psychiatric professional fees |
Pharmacy
Pharmacy prior authorizations can be requested through Availity.
You can also request prior authorization by calling:
Hours of operation: Monday-Friday, 8 a.m. to 8 p.m.
Hoosier Healthwise:
866-408-6132
Healthy Indiana Plan:
844-533-1995
Hoosier Care Connect:
844-284-1798
Fax:
Retail:
844-864-7860
Medical Injectables:
888-209-7838
Services billed with the following revenue codes ALWAYS require precertification:
0632 | Pharmacy multiple sources |
The following ALWAYS require precertification:
Elective services provided by or arranged at nonparticipating facilities
All services billed with the following revenue codes:
0023 | Home health prospective payment system |
0570–0572, 0579 | Home health aid |
0944–0945 | Other therapeutic services |
3101–3109 | Adult day and foster care |
Prior authorization - Phone
Utilization Management, Behavioral Health and Pharmacy
Hours of operation: Monday-Friday, 8 a.m. to 8 p.m.
Hoosier Healthwise:
866-408-6132
Healthy Indiana Plan:
844-533-1995
Hoosier Care Connect:
844-284-1798
Prior authorization - Fax
Physical health inpatient and outpatient services:
Fax
866-406-2803
Concurrent reviews for inpatient, skilled nursing facility, long-term acute care hospital and acute inpatient rehabilitation:
Fax
844-765-5156
Submission of clinical documentation as requested by the Anthem Blue Cross and Blue Shield outpatient Utilization Management department to complete medical necessity reviews for outpatient services such as DME, Home Health care, wound care, orthotics, and out-of-network requests should be faxed to 844-765-5157. For AIM-related CPT® codes, all requests are initiated by AIM Specialty Health®* online at //aimspecialtyhealth.com or by calling 844-767-8158. You may also access the Precertification Lookup Tool directly here.
* AIM Specialty Health is an independent company providing some utilization review services on behalf of Anthem Blue Cross and Blue Shield.
Fax
844-765-5157
Related resources
- Medical Policies and Clinical UM Guidelines Search
- AIM Specialty Health Guidelines
- Universal Authorization Form
Documents
- DME Rental List
- Medical Necessity Code List
- Retail Pharmacy Prior Authorization Forms
- Medical Injectable Prior Authorization Form
- Synagis Prior Authorization Form
- Submit prior authorizations online with Interactive Care Review
- Behavioral Health outpatient authorization process
- Home Health wound care update
- Indiana Medicaid Prior Authorization Requirements List
Page Last Updated: 10/11/2021
Provider tools & resources
- Log in to Availity
- Learn about Availity
- Precertification Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Provider Manuals and Guides
- Referrals
- Forms
- Training Academy
- Pharmacy Benefits
- Electronic Data Interchange (EDI)
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We look forward to working with you to provide quality services to our members.