Capital blue cross prior authorization form pdf

Capital BlueCross’s Preferred Method for Prior Authorization Requests

Our electronic prior authorization (ePA) solution provides a safety net to ensure the right information needed for a determination gets to patients' health plans as fast as possible.

Improving efficiencies without sacrificing the essentials

  • 70%1 of users reported time savings
  • 35%2 faster determinations than phone or fax
  • HIPAA compliant and available for all plans and all medications
  • No cost to providers and their staff

Capital blue cross prior authorization form pdf

How it works

Three Easy steps to completing requests electronically

  1. Create a free account in minutes
  2. Verify your NPI to receive all requests initiated at your patient’s pharmacies
  3. Use your account to initiate, access and submit requests

Want to learn more? Join a webinar.

I have been using this service since last year and it simply gets better and better. It has significantly reduced the paperwork burden of my office and office staff as far as prior authorizations go.

CoverMyMeds Provider

Dedicated Support

No hold times.
No phone trees.

We know PA requests are complex. That's why we have a team of experts and a variety of help resources to make requests faster and easier.

LET’s GET STARTED

1 - CoverMyMeds Provider Survey, 2019

2 - Express Scripts data on file, 2019

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Is Capital Blue the same as Blue Cross?

Capital BlueCross is an independent licensee of the BlueCross BlueShield Association. For more information, visit capbluecross.com or CapitalBlueStore.com.

What is PPO preauthorization?

A decision by your health insurer or plan that a health care service, treatment plan, prescription drug or durable medical equipment is medically necessary. Sometimes called prior authorization, prior approval or precertification.

What is Capital Blue Cross CAIC?

Authority to do business: Capital Blue Cross is a non-profit hospital plan corporation. Capital Advantage Insurance Company ("CAIC") is a wholly owned subsidiary of Capital Blue Cross that is a licensed insurer with accident and health authority.

How do I submit a claim to Capital Blue Cross?

If you need to submit a medical claim to us, you should request an itemized bill from your health care provider. Submit the itemized bill to us with a completed claim form. Contact Member Services at 800.730. 7219 (TTY: 711) if you need help submitting a medical claim.