Spring 2009

Avoid payment delays: Verify physician name prior to rendering preauthorized services

When requesting an electronic or phone prior authorization for member services, providers must submit the name of the practitioner who will be rendering the authorized services. Submitting the claim with a different rendering practitioner’s name delays payment because the name does not match the authorization for services contained within our payment system.

You can avoid this type of claim payment delay. Before preauthorized services are rendered, verify through either the Availity^®1 Health Information Network or Blue Express that the name of the treating practitioner matches the name provided in the preauthorization. If the rendering provider has changed, update the authorization information.

If you have any questions about this information, please call Authorizations/Pre-Service Medical Review at (800) 955-5692.