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Update to Spine Preauthorization Process

Date:
June 26, 2020

To: Orthopedic Surgeons, Neurosurgeons, Physiatrists, Anesthesiologists, Interventional Radiologists, and Pain Management Specialists

Contracts affected: Commercial and Medicare Advantage

To help streamline the preauthorization process for spine procedures and injections, all of these requests will be submitted directly to our Utilization Management Department beginning October 1, 2020. We will no longer require any requests to be submitted through Palladian Health.

As we centralize these preauthorization requests at BlueShield, a completed Elective Surgery Preauthorization form will need to be submitted by fax to our Utilization Management department at the fax number listed on the form. You can call us at 1-800-677-3086 with any questions about preauthorization or the form.

Requests for patients covered by administrative services only (ASO) plans are currently submitted directly to us. To simplify your workflow, all spine-related preauthorization requests, (including those for Commercial and Medicare Advantage patients), will be submitted to our Utilization Management team beginning on October 1.

We also continue to evaluate the need to require preauthorization for certain codes. As we have been doing for the past several years, we will remove codes as we determine that they are no longer appropriate for preauthorization. You can log onto our provider portal and search our Code and Comment tool by code to determine whether a preauthorization request is required.  

If you have any questions about this change in process, please contact Provider Service at 1-800-444-4552 or (518) 220-5620.

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