Notice of Upcoming Change to Prior-Authorization Documentation Submission Process

Blue Cross Blue Shield of North Dakota (BCBSND) wants to inform providers of a change regarding submission of medical record documentation on an authorization request already received by BCBSND that will be coming this fall.

Today, after a prior authorization case is submitted, providers can add medical records and/or documentation to the case at any time. However, effective Oct. 17, 2025, additional documentation will no longer be allowed to be added after a case has been submitted to BCBSND.

Why is BCBSND making this change?

There are several reasons for this change:

• It will ensure all relevant information gets reviewed.
• Reduces the risk of information being missed if a case is already sent for medical director review.
• Decreases risk of increased wait time if a case needs additional review due to added information.
• Reduces risk during audits if documentation was added after a determination was already made.

How can I ensure my case is reviewed with all relevant documentation?

As best practice, providers should submit a new prior authorization once all documentation is completed and ready to be sent to BCBSND.

I submitted my case and realized I forgot to add pertinent documentation, what can I do?

If a provider needs to add documents to a case already received by BCBSND, a call will need to be made to the Utilization Management (UM) phone line 800-952-8462 to discuss further.

UM tech will look at the submitted case to determine if additional information can still be submitted. If it can, a request for additional information (RFAI) task will be pushed back to the provider through the Availity Essentials Provider Portal.

Questions?

If you have questions regarding this change, please contact prov.partners@bcbsnd.com.