Precertification/Preauthorization

Preauthorization is the process of notifying Blue Cross Blue Shield of North Dakota (BCBSND) to request approval for specified services.

The participating provider is responsible for obtaining preauthorization of covered services on behalf of the member. If a patient is transferred from one type of facility to another, the provider receiving the patient is responsible for obtaining preauthorization.

Preauthorization is required for the services listed below. To obtain preauthorization for these services, call the following numbers:

Services

Phone Numbers

Skilled Nursing Facility
Transitional Care Unit
Inpatient Admission to a Rehabilitation Facility
Hospice
Home Health Care

Toll Free:
1-800-336-2488
Local:
701-277-2100

Medical/Surgical Out-of-Area Inpatient Admissions

Inpatient Acute Medical/
Surgical Admission Notification

Toll Free:
1-800-952-8462
Local:
701-282-1200

Psychiatric/Substance Abuse Admissions

Out of State Providers —
Inpatient Psychiatric and Substance Abuse Admission

Toll Free:
1-800-825-6614
Local:
701-282-1881

Case Management/Long-Term Acute Care Facility

Toll Free:
1-800-336-2488
Local:
701-277-2100

 

Note: No preauthorization is required when Blue Cross Blue Shield of North Dakota is secondary to other insurance, unless other insurance benefits have been exhausted. No preauthorization is required for maternity admissions that result in delivery.

This list does not apply to the Federal Employee Program (FEP).