Prior Authorization Exemption Communication Method Preference

As indicated in HB3459 for Prior Authorization (PA) Exemptions, providers have the opportunity to request the method to receive their PA exemption status*. Blue Cross and Blue Shield of Texas (BCBSTX) will be sending out notifications for the July - Dec. 2022 review period by March 1.

Electronic Access to PA Exemption Status

As we did with the original notifications effective Oct. 1, 2022, all notifications will be available through the Prior Authorization Exemption Status Viewer on the secure section of the BCBSTX-branded Availity® Payer Spaces. If you are not currently registered for Availity, you can do so at no charge on Availity Essentials or by contacting Availity Client Services at 1-800-282-4548 to get access. This is the easiest and quickiest method to access your PA exemptions. Refer to Prior Authorizatons Exemptions page on the BCBSTX provider website for how to access notifications on Availity.

Alternate PA Exemption Communication Methods

If you prefer to have your PA exemption status communication sent via an alternate method (email or postal mail), you must submit the request by Feb. 6, 2023 by completing the Prior Authorization Exemption Communication Method Preference Questionnaire.

If we do not receive an alternate preference by Feb. 6, 2023, your PA exemption will be available via Availity by Mar. 1, 2023.  If you have previously submitted a questionnaire and have no changes, we will continue to honor your requested preference.

* Prior authorization exemption notice preferences for prior authorizations managed by a Pharmacy Benefit Manager (PBM) may be conveyed by the PBM.

More Information:

Refer to our provider website for more information on Prior Authorization Exemptions.

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.