Name of Manual - Blue Cross and Blue Shield of Minnesota

Behavioral Health
Quality Improvement
Objectives (continued)
Coding Policies and Guidelines (Behavioral Health)
Questions, comments or material requests should be directed to:
Attn: Mary Rains R4-18
Blue Cross and Blue Shield of Minnesota and Blue Plus
P.O. Box 64179
St. Paul, MN 55164-0179
Phone: (651) 662-0826 or 1-800-382-2000 x20826
Fax: (651) 662-3625
E-mail: mary_e_rains@bluecrossmn.com
Prior Authorization Blue Cross does not usually require prior authorization for
outpatient mental health or chemical dependency services provided
within the Select or Aware ® provider networks, depending on
specific contract requirements. Likewise, if the patient has benefits
for behavioral health services from a non-network provider, no
prior authorization is usually required. If the patient does NOT
have benefits for behavioral health services from a non-network
provider, there is no coverage and claims will deny as “not
covered.”
A few groups do have specific prior authorization requirements for
behavioral health services. Contact provider services for a specific
group’s requirements:
Phone: 1-800-262-0820 or (651) 662-5200
Fax: (651) 662-2745
Federal Employee Program ® (FEP) (member ID numbers begin
with “R”) members require a prior authorization for all outpatient
mental health and substance abuse services before the first visit.
To request a prior authorization, complete the Minnesota universal
outpatient mental/chemical health authorization form that is
available on bluecrossmn.com. Select “for health care providers”
then “forms and publications” and in the drop down box, select
“forms: prior authorization.” If you have questions regarding FEP
members:
Phone: (651) 662-5044 or 1-800-859-2128
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual 06/19/12 11-53