BlueApprovR is an online tool accessible in Availity® Essentials that allows providers to submit inpatient and/or outpatient prior authorization and recommended clinical review (RCR) requests for medical/surgical, specialty pharmacy drugs, and behavioral health services for BCBSTX members.
BlueApprovR is designed to help simplify the provider submission process by asking for the information to support a medical necessity determination.
Registered Availity Essentials users have free, 24/7 access to BlueApprovR tool to:
- Secure real-time approvals for certain services and begin treatment right away
- Easily attach medical records
- Check approval status
Use BlueApprovR to request prior authorization for these types of care:
- Inpatient Acute Care
- Long-term Acute Care
- Inpatient Rehab
- Skilled Nursing Facility
- Outpatient Hospice
- Inpatient Hospice
- Home Health
- Outpatient Service
How to Access BlueApprovR:
- Log in to Availity Essentials
- Select Payer Spaces from the navigation menu and choose BCBSTX
- Within Payer Spaces, select the Applications tab and click BlueApprovR
- Users will be redirected to BlueApprovR to complete the request online
Training Sessions:
Weekly instructor-led training sessions are available for BlueApprovR. Visit our Training page to select your preferred date and time to register.
Resources and Support:
- See our quick overview on the value of using BlueApprovR
- Refer to the BlueApprovR User Guide to learn how to access and use BlueApprovR via Availity Essentials.
- The Blue ApprovR Behavioral Health Concurrent Review User Guide assists with requesting concurrent review for prior authorization requests that have been previously submitted and approved through BlueApprovR.
- For additional education and training, contact the BCBSTX Provider Education Consultants.
- If you need technical assistance with this tool, contact the BlueApprovR Support Team.
Note: This tool is currently not applicable to Medicare Advantage, Texas Medicaid, Federal Employee Program® (FEP®), Employees Retirement System of Texas (ERS) or Teacher Retirement System’s (TRS) members.
Checking eligibility and/or benefit information and/or obtaining prior authorization 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, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member's ID card.
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.