Search BlueAccess® Login/Pay Bill HOME PROVIDERS HOME PRECERTIFICATION AND PRIOR-AUTHORIZATION Precertification and Prior-Authorization Body Need to create a new pre-certification request for your patient or to view the status of an existing pre-certification request? Visit the secure pre-certification section. Sign-in to Availity Members of some group health plans may have terms of coverage or benefits that differ from the information presented here. The following information describes the general policies of Blue Cross and Blue Shield of Kansas (BCBSKS) and is provided for reference only. This information is NOT to be relied upon as prior-authorization or precertification for health care services and is NOT a guarantee of payment. To verify coverage or benefits or determine pre-certification or preauthorization requirements for a particular member, call 800-676-BLUE or send an electronic inquiry through your established connection with your local Blue Plan. PRE-CERTIFICATION / PREAUTHORIZATION INFORMATION FOR OUT-OF-AREA MEMBERS To view the out-of-area Blue Plan's general pre-certification/preauthorization information, enter the first three letters of the member's identification number on the Blue Cross Blue Shield ID card, and click "GO." Alpha prefix: If you experience difficulties or need additional information, please contact 800-676-BLUE. PRE-CERTIFICATION REQUIRED All in-patient medical stays (requires secure login with Availity) 800-782-4437 All in-patient mental health stays 800-952-5906 All home health and hospice services 800-782-4437 Transplants with the exception of cornea and kidney 800-432-0272 Disclaimer: Some employer groups have some specific items that require prior authorization. Call for more information. PREDETERMINATION/PRIOR-AUTHORIZATION REQUIRED Please complete and fax the BCBSKS predetermination or prior authorization form embedded within each policy below: ACA Prevention Copay Waiver Criteria – Individual Marketplace, Commercial Compounded Prescriptions Genetic Testing for BRCA1 or BRCA2 for Hereditary Breast/Ovarian Cancer Syndrome and Other High-Risk Cancers Human Growth Hormone Intravenous and Subcutaneous Immune Globulin Therapy Site of Care Infusion Management Zolgensma All other drugs may be prior authorized electronically by completing the prior authorization form through CoverMyMeds. If you need medical policies for these drugs, you will find a list below the CoverMyMeds form. Need a PA form? 1. State Select your state 2. Drug Choose a drug 3. Plan e.g. “004336 MEDDADV RXCVSD” or “SilverScript” or “Express Scripts” START REQUEST What is CoverMyMeds? Many of our pharmacy medical policies are now being maintained through our pharmacy benefit manager, Prime Therapeutics. To find pharmacy medical policies specific to a medication list, use the links below. BCBSKS BlueCare/EPO Prior Authorization (offsite link) BCBSKS ResultsRx Prior Authorization (offsite link) BCBSKS Select Prior Authorization (offsite link) Policies may be temporarily housed here prior to being posted to the myprime.com website. Elagolix/Relugolix Prior Authorization with Quantity Limit Criteria Careers Work for one of the most trusted companies in Kansas. APPLY NOW Information Contact Us Privacy and Legal Help Careers En Español Non-Discrimination, Translation and Interpretation Services Site Resources Glossary Security Tips Contact Webmaster Blue Cross and Blue Shield of Kansas is an independent licensee of the Blue Cross Blue Shield Association. Blue Cross and Blue Shield of Kansas serves all counties in Kansas except Johnson and Wyandotte. ®Registered Trademarks of the Blue Cross Blue Shield Association. If you have any questions or comments about this site, please notify our webmaster.