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  • Special Authorization Request Form - Alberta Blue Cross

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SPECIAL AUTHORIZATION REQUEST FORM Please complete all required sections to allow your request to be processed. Patients may or may not meet eligibility requirements as established by Alberta Government.

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Requests for authorization for BCBS Michigan members can be submitted directly through your local Blue plans electronic portal via the Electronic Provider Access system (EPA). BCBSM encourages the use of the Electronic Provider Access system (EPA) to effectively and efficiently respond to your request.

Prior authorization (also called “preauthorization” and “precertification”) refers to a requirement by health plans for patients to obtain approval of a health care service or medication before the care is provided. This allows the plan to evaluate whether care is medically necessary and otherwise covered.

Alberta Blue Cross® administers Non-Group Coverage on behalf of Alberta Health. For more information about the Non-Group Coverage program, including an application form and eligibility information, please visit Alberta Health.

What is prior authorization? This means we need to review some medications before your plan will cover them. We want to know if the medication is medically necessary and appropriate for your situation. If you don't get prior authorization, a medication may cost you more, or we may not cover it.

Call Alberta Blue Cross® Customer Services at 780-498-8000 (Edmonton and area), 403-234-9666 (Calgary) or 1-800-661-6995 (toll-free from anywhere else in Alberta).

If you think your drug may require a prior authorization, call your insurer directly to confirm.

Special Authorization and Prior Authorization are interchangeable terms we use to describe a pre-approval process that helps us determine if certain prescription drugs will be reimbursed under your benefit plan. Most drugs that require prior authorization are considered high-cost specialty drugs.

When your doctor decides that you need a service or medication, and it requires pre-authorization from your health plan, your doctor's office will put a request into your health plan to get approval to perform the service or for the pharmacy to fill the prescription.

Special authorization benefits Special authorization is a mechanism to provide access to certain drugs ing to defined clinical criteria. Special authorization request forms are completed by physicians and reviewed by clinical pharmacists. Prior approval must be granted to ensure coverage by special authorization.

No authorization means no payment. Insurers won't pay for procedures if the correct prior authorization isn't received, and most contracts restrict you from billing the patient. PA denials result in lost revenue, declines in provider and patient satisfaction, and delays in patient care.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232