June 13, 2025
We’re adjusting the turnaround time for processing prior authorization requests for our members with Blue Cross Community Health PlansSM. This is due to a change to our HealthChoice contract with the state of Illinois.
Effective July 1, 2025, the turnaround time for non-urgent Medicaid prior authorization requests will be extended to five days with a possible additional five days (10 total days) if there’s a need for additional written information to make a determination.
The turnaround time for urgent requests will remain at 48 hours but can be extended for an additional 24 hours (72 hours total) if sufficient clinical information isn’t received to make a determination.
Please submit clinical documentation at the time of the initial prior authorization request to ensure timely processing.
More information: Continue to watch News and Updates for information on BCCHPSM and other programs and initiatives at Blue Cross and Blue Shield of Illinois.
Always check eligibility and benefits first through Availity® Essentials or your preferred web vendor to confirm prior authorization requirements and utilization management vendors.
If you have any questions on member benefits, call the number on the member’s ID card.
Checking eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have any questions, please call the number on the member’s ID card.
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