WebInsert Attachments. Checking this box will send a copy of your form to the email address provided. For Blue Card members, suffix is not required. Medications Blue Cross and Blue Shield of Kansas City Find a Form Claim Inquiry Form | Download An independent licensee of the Blue Cross and Blue Shield Associationdocument.write(new Date().getFullYear()) Blue Cross and Blue Shield of Kansas City. Box 412735 To upload multiple files, hold down the CTRL key while selecting multiple documents then click open. Diagnosis Codes must be 3-8 characters along with decimals. Follow these instructions to activate and enable JavaScript in Firefox. Kansas City, MO 64141-2735. UseSpecial Authority eFormsto submit requests. bcbs kc formulary exception form. The online form Credentialing Status. Select your browser type and follow these instructions to activate and enable JavaScript or contact your administrator if you continue to experience issues. Thank you. Follow these instructions to activate and enable JavaScript in Internet Explorer. All rights reserved. Open a new Firefox browser window or tab. With tools and actionable data to support more coordinated, targeted care, you can reduce unnecessary If yes, please attach a copy of the last sleep study. IMPORTANT: If you are an FEP Member, enter "NA" into the Prefix field. Follow these instructions to activate and enable JavaScript in Safari. To ensure the proper functionality of electronic forms you must have JavaScript enabled and be using a current version of your browser. Questions about the collection of information can be directed to the Manager of Corporate Web, Government Digital Experience Division. bcbs kc for providers. If you do not have your member ID card, contact the Customer Service department by clicking Contact Us, or calling 816-395-3558 or 888-989-8842. Copy the following then paste it into the Firefox address bar: To the right of the address bar, click the icon with. https providers bluekc com WebFor providers who would like to continue submitting Prior Authorization requests through Blue KC's eForms (until the 1/1/2021 date), use the eForm pages listed below: Prior Follow these instructions to activate and enable JavaScript in Opera. WebCheck the initial credentialing status for new providers. IMPORTANT: If you are an FEP Member, enter "NA" into the Prefix field. Checking this box will send a copy of your form to the email address provided. Site of Care Authorization Provider Login If you can't find theform you need below, search for the drug in the, Employment, business and economic development, Employment standards and workplace safety, Birth, adoption, death, marriage and divorce, Environmental protection and sustainability, Tax verification, audits, rulings and appeals, Transportation and infrastructure projects, Fraser Valley Highway 1 Corridor Improvement Program, Highway 1 - Lower Lynn Improvements Project, Belleville Terminal Redevelopment Project, How to submit a Special Authorityrequest, CGM, insulin pumps and blood glucose test strips, General Special Authority Request (PDF, 656KB), Donepezil, Galantamine and Rivastigmine (PDF, 350KB), Standardized Mini-Mental State Examination (SMMSE) (PDF, 690KB), Global Deterioration Scale (GDS) (PDF, 198KB), Letermovir Special Authority Request Form (PDF, 358KB), Rivaroxaban for Concomitant Coronary Artery Disease and Peripheral Artery Disease (PDF, 362KB), BASDAI (Bath 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Follow these instructions to activate and enable JavaScript in Safari. See the sample ID card above. A service or medication may require a prior authorization based on your patients plan. bcbs of kansas prior authorization forms. To upload multiple files, hold down the CTRL key while selecting multiple documents then click open. Your Suffix is a two digit number located on your Member ID card. WebSite of Care Authorization. If you experience issues submitting this form, please print and fax it to (816) 817-8211. To upload multiple files, hold down the CTRL key while selecting multiple documents then click open. Choose a file or files to attach (File types accepted: jpg, txt, doc, docx, pdf, xls, xlsx, ppt, pptx, rtf, tiff, and tif). Follow these instructions to activate and enable JavaScript in Chrome. If you do not have your member ID card, contact the Customer Service department by clicking Contact Us, or calling 816-395-3558 or 888-989-8842. If you do not have your member ID card, contact the Customer Service department by clicking Contact Us, or calling 816-395-3558 or 888-989-8842. Agents & Providers - Blue Cross and Blue Shield of Kansas City Live Healthy With Blue KC | Kansas City Health Insurance If the medication you are looking for is a new-to-market drug, or is not listed, please submit a Prior Authorization WebNote: Review of your form and potential reimbursement will be slower than online submissions. Provider Login PROVIDER LOGIN Blue KC has implemented a medical policy to require administration of certain medications in the most cost-effective site of care that is clinically appropriate for a members condition. P.O. Special Authority requests must be completed by a licensed medical prescriber. Obtain forms for: Pre-authorization Pharmacy, Pre-service, Utilization Management, and; Little Stars See the sample ID card above. See the sample ID card above. Follow these instructions to activate and enable JavaScript in Firefox. Register Now Username Password How to Use the Provider Portal Patients may also access their own medication history, including Special Authority requests, through Health Gateway. Blue Cross and Blue Shield of Kansas City Copy the following then paste it into the Firefox address bar: To the right of the address bar, click the icon with. WebPrior Authorization. Checking this box will send a copy of your form to the email address provided. WebTo continue your electronic prior authorization request, log in. Do not send a request by fax as faxed requests will not be responded to. To ensure the proper functionality of electronic forms you must have JavaScript enabled and be using a current version of your browser. Find A Form - Blue Cross and Blue Shield of Kansas City Follow these instructions to activate and enable JavaScript in iOS on the iPhone and iPad. Follow these instructions to activate and enable JavaScript in Internet Explorer. Follow these instructions to activate and enable JavaScript in iOS on the iPhone and iPad. If you do not have your member ID card, contact the Customer Service department by clicking Contact Us, or calling 816-395-3558 or 888-989-8842. Credentialing Status. It is on the front of your Member ID card. See the sample ID card above. SeeHow to submit a Special Authorityrequest. Follow these instructions to activate and enable JavaScript in Chrome. WebAll new-to-market medications will require a Prior Authorization. Note that not filling in required fields (Marked with an *) will cause your submission to be rejected. Last updated: January 23, 2023 Use Special Authority eForms to submit requests. WebClaims Prior Authorization Resources Medical Policies Account Forms Ensure you are using the latest web browser version in order to submit electronic forms. If you experience issues submitting this form, please try again later. Provider Login Not Registered for the Provider Portal? Webproviders may continue submitting pre-determination requests for Federal Employee Program (FEP) and Joint Administrative Account (JAA) lines of business. eForms are easier to submit and return decisions quicker than faxing paper forms. Pharmacy Services Box 412735 Prior Authorization Changes for Blue Cross and Blue Shield of See the sample ID card above. Your Suffix is a two digit number located on your Member ID card. To ensure the proper functionality of electronic forms you must have JavaScript enabled and be using a current version of your browser. *, Choose a file or files to attach (File types accepted: jpg, txt, doc, docx, pdf, xls, xlsx, ppt, pptx, rtf, tiff, and tif). Your member ID is a unique number that identifies your plan. WebSleep study, simultaneous recording of ventilation, respiratory effort, ECG or heart rate, and oxygen saturation, attended by a technologist. See the sample ID card above. Note that not filling in required fields (Marked with an *) will cause your submission to be rejected. Forms Select your browser type and follow these instructions to activate and enable JavaScript or contact your administrator if you continue to experience issues. abatacept, adalimumab, certolizumab, etanercept, golimumab, infliximab, rituximab, tocilizumab, Attention deficit hyperactivity disorder (ADHD), mixed-amphetamine salts ER, lisdexamfetamine, methylphenidate ER (Concerta-type generics), atomoxetine, deferasirox, iron isomaltoside, iron sucrose, dabigatran, rivaroxaban, ticagrelor, ivabradine,sacubitril-valsartan, ARBs(candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, valsartan), empagliflozin, empagliflozin-metformin, insulin detemir, insulin glargine, insulin pump,linagliptin, pioglitazone, saxagliptin, semaglutide, proton pump inhibitors, adalimumab, infliximab, rifaximin, vedolizumab, obeticholic acid, Hepatitis B: adefovir, entecavir, interferon alpha, lamivudine, tenofovir Your prefix is on the front of your Member ID card. Your feedback is greatly appreciated. Enrol now. It is on the front of your Member ID card. Jump toCGM, insulin pumps and blood glucose test strips|Compounded medications, General Special Authority request (use only if there is no specific form below). Follow these instructions to activate and enable JavaScript on your Android. Kansas City, MO 64141-2735. See the sample ID card above. See the sample ID card above. Blue KC | Employer | Prior Authorization Choose a file or files to attach * (File types accepted: jpg, txt, doc, docx, pdf, xls, xlsx, ppt, pptx, rtf, tiff, and tif). Blue Card 816-395-3860. Webbcbs kc inquiry form. Submitting this feedback form does not include a submission of your form request. WebIf you are using one of these devices please use the PDF to complete your form. Incompleteforms will not be processed. WebIf you experience issues submitting this form, please print and fax it to one of the following: Local HMO/PPO 816-278-1944. WebWe empower providers in our networks to improve care delivery for you. WebCheck the initial credentialing status for new providers. Your feedback is greatly appreciated. Choose a file or files to attach (File types accepted: jpg, txt, doc, docx, pdf, xls, xlsx, ppt, pptx, rtf, tiff, and tif). Blue KC will provide coverage for Sleep Studies when it is determined to be medically necessary. * If yes, why? If you experience issues submitting this form, please try again later. Follow these instructions to activate and enable JavaScript on your Android. Claim Inquiry Obtain forms for: Pre-authorization Pharmacy, Pre-service, Utilization Management, and; Little Stars Provider Login Open a new Firefox browser window or tab. See the sample ID card above. An independent licensee of the Blue Cross and Blue Shield Associationdocument.write(new Date().getFullYear()) Blue Cross and Blue Shield of Kansas City. WebEffective 2/1/2020, Blue KC discontinued accepting pre-determination requests. Follow these instructions to activate and enable JavaScript in Firefox. Your prefix is on the front of your Member ID card. Follow these instructions to activate and enable JavaScript on your Android. Medical/Dental Claim Form | Download PDF. Blue KC has implemented a medical policy to require administration of certain medications in the most cost-effective site of care that is clinically appropriate Claims Inquiry Form ; Itemized Bill Submission Form; Medical/Dental Claim Form ; Pharmacy Claim Prior Authorization Other Specialty Medications For Blue Card members, suffix is not required. Excessive daytime sleepiness *, Epworth Sleepiness Score: Chronic pulmonary disease (i.e., severe or uncontrolled asthma, COPD, sarcoidosis) *. An independent licensee of the Blue Cross and Blue Shield Associationdocument.write(new Date().getFullYear()) Blue Cross and Blue Shield of Kansas City. Follow these instructions to activate and enable JavaScript in Internet Explorer. Submitting this feedback form does not include a submission of your form request. Bcbs Kansas City Prior Authorization Form - Fill Out and Sign You can access the e If you can't find theform you need below, search for the drug in theSpecial Authority drugslist. WebPrior Authorization Blue Cross and Blue Shield of Kansas City (Blue KC) may require prior authorization before certain medical services and/or medications are performed or
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