Utilization Management (UM) Courtesy Pre-Determinations (CPD)

Effective March 15, 2020, Utilization Management will no longer provide an approval or denial on a courtesy pre-determination request when a medical policy exists (Federal Employee Program (FEP) excluded). If the service requested has a medical policy and doesn’t require precertification, the provider will receive a fax with the following information:

The service requested does not require a precertification. Please see the applicable published medical policy which may be found at www.bcbsnd.com/providers/policies-precertification. For additional questions, please contact Provider Services.