The BlueApprovR utilization management tool is now integrated with Availity® Authorizations at Availity Essentials. The new configuration will assist you with the authorization process for behavioral health services.
BlueApprovR is designed to help simplify the provider submission process by asking for the information to support a medical necessity determination.
To submit initial prior authorizations online:
- In Availity, select Patient Registration from the navigation menu
- Then select Authorizations & Referrals
- On the Authorizations & Referrals page, select Authorization Requests
At this time, Behavioral Health concurrent reviews and edits are only be supported via phone & fax.
- Providers may call the number on the member's card and follow voice prompts to connect with a clinician to request telephonic clinical concurrent reviews and edits.
Concurrent and edit functionality is scheduled to go live in Availity Authorizations later this summer.
For additional details, refer to Availity Authorizations Tools to learn more and view instructional user guides.
Training Sessions:
Weekly instructor-led training is available for you to learn how to electronically submit your request via Availity. Select your preferred date and time to register. You must be a current Availity user to register and attend these training sessions.
Note: This behavioral health/BlueApprovR integration with Availity Authorizations is currently not available for New Mexico Medicaid members. Please use your existing process for requesting prior authorization for these members.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.