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Click ‘Get Form’ to open the Predetermination Request Form in the editor.
Begin by filling out the 'Provider Data' section. Include the date, provider/group name, and contact details such as telephone and fax numbers.
Next, complete the 'Member Data' section. Ensure you provide the member identification number, group number, and both patient and member names along with their dates of birth.
In the documentation area, attach any supporting documents that facilitate your review. Check all applicable items for review requirements.
Finally, ensure all fields are filled accurately before submitting. Fax the completed form to 800-852-1360 using our platform for a streamlined process.
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A recommended clinical review is a review of a proposed treatment by your insurers medical staff. During this review, the experts evaluating the clinical recommendation will decide if they agree that the treatment is right for your health needs. Recommended clinical reviews are done before you get care.
What number is 1 800 676 2583?
Telephone: Call BlueCard Eligibility at 800-676-BLUE (2583).
How do I speak to a person at BCBS?
Call the toll-free number on the back of your member ID card for BCBS customer service. This is the customer service number for questions about your health insurance coverage, benefits or treatment.
What is the phone number for Montana provider?
For more information, please contact Montana Provider Relations at (800) 624-3958 or (406) 442-1837 or email: MTPRHelpdesk@conduent.com. Thank you for understanding.
What is a predetermination obtained by provider?
A recommended clinical review (formerly called predetermination) is a medical necessity review conducted before services are provided. Submitting the request prior to rendering the services is optional and informs the provider and member of situations where a service may not be covered based upon medical necessity.
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What is the phone number for BCBS of Montana provider services?
If you dont have online access or need to make an adjustment, you may call provider customer service numbers for assistance: Commercial claims 800-447-7828* Federal Employee Program (FEP) claims 800-634-3569. Healthy Montana Kids (HMK) claims 855-258-3489.
What is the phone number for BCBS Montana Federal providers?
Checking via Telephone If you dont have online access or need to make an adjustment, you may call provider customer service numbers for assistance: Commercial claims 800-447-7828* Federal Employee Program (FEP) claims 800-634-3569. Healthy Montana Kids (HMK) claims 855-258-3489.
blue cross blue shield of illinois predetermination form
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