Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Behavioral Health)
Prior Authorization
(continued)
11-54
Providers may use the following numbers to submit a prior
authorization request, check on the status of a prior authorization
request, or ask questions about prior authorization guidelines for
Behavioral Health Services.
Phone: 1-800-262-0820
Fax: (651) 662-0854 outpatient or inpatient behavioral health
services
Providers should submit a new prior authorization request when
requesting additional services or a change in dates of service for a
prior authorization.
Referrals Blue Cross does not require a referral for patients seeking care
within the Select Behavioral Health Network. For complete
information on requirements for Minnesota Health Care Programs,
see Chapter 3 of the Blue Plus Manual.
Preadmission
Notification
Services sought outside the Select Behavioral Health Network but
within the Aware network will be processed according to the
patient’s self-referral benefit, if the patient’s contract has a selfreferral
benefit. If the patient has specialty needs, continuity of
care issues, transition of care issues, or cannot access behavioral
health services within the required provider network within a
reasonable time period, or due to geographical or physical
accessibility reasons, the provider should contact Blue Cross and
request a referral. A referral will be approved depending on the
patient’s situation.
If services are sought outside both the Select network and the
Aware network and the member does not have self-referral
benefits, then Blue Cross should be contacted and the situation
reviewed for a possible referral approval.
Call (651) 662-2474 or 1-800-262-0820 or fax form X13459 to
(651) 662-0856 to notify Blue Cross of admissions into day
treatment, partial psychiatric or inpatient programs.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual 06/19/12