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19 11/2005
Preauthorization
The provider is responsible for verification of member eligibility and covered
benefits. Except when an emergency, failure to obtain authorization prior to
rendering designated services (listed below and as required in the Benefit Plan) will
result in a denial of reimbursement. There are now some outpatient diagnostic
procedures which can be preauthorized through our web site (www.bcbsga.com),
click on Provider Access and go to on-line transactions. The procedures that are
available on the web site are indicated in the table below. A minimum timeframe
of three (3) business days is required to complete a thorough clinical analysis prior
to the member’s proposed elective procedure date. An authorization number will
be returned to your office within three (3) business days of receipt of complete
clinical information. The format of the number can be alpha numeric or plain
numeric. Contracted facilities must notify BCBSGa within twenty-four (24) hours or
the next business day from the time of all inpatient admissions.