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Some services, procedures, and equipment requires precertification before the service is performed. The ordering provider is typically responsible for obtaining precertification.
NOTE: Any service that is potentially cosmetic does require precertification.
NOTE: Dental anesthesia and hospitalization for dental care, precertification is required for all Members age 9 and older.
Nonparticipating providers:
Providers typically submit precertification requests on members' behalf. While not required for nonparticipating providers, it is appreciated by BCBSND members.
NOTE: The search results listed do not apply to the Federal Employee Program (FEP). Please refer to the FEP website or contact FEP Provider Services
Unable to submit through Availity Essentials?
Inpatient Authorization Request
Outpatient Authorization Request
ABA Services for Autism Spectrum Disorder Supplement - This form is to accompany the appropriate authorization request
Repetitive Transcranial Magnetic Stimulation (rTMS) Authorization Request