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In California Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association.
Payer Name and ID Your payer name is Anthem BC California and the payer ID is 47198 (If you use a billing company or clearinghouse for your EDI transmissions, please work with them on which payer ID they want you to use.)
No pre-authorization is required for outpatient emergency services as well as Post-stabilization Care Services (services that the treating physician views as medically necessary after the emergency medical condition has been stabilized to maintain the patient's stabilized condition) provided in any Emergency Department ...
What is a Prior Authorization? A prior authorization (PA), sometimes referred to as a \u201cpre-authorization,\u201d is a requirement from your health insurance company that your doctor obtain approval from your plan before it will cover the costs of a specific medicine, medical device or procedure.
Prior authorization (also called \u201cpreauthorization\u201d and \u201cprecertification\u201d) 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.
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The prior authorization process can help you: Reduce the cost of expensive treatments and prescriptions by first requiring you to try a lower-cost alternative. Avoid potentially dangerous medication combinations. Avoid prescribed treatments and medications you may not need or those that could be addictive.
Prior authorizations Anthem makes determinations based on selected inpatient or outpatient medical services including surgeries, major diagnostic procedures, and referrals to validate medical necessity. Prior authorization requirements.
Your insurance company may require prior authorization before covering certain prescriptions. This is to ensure that the medication is appropriate for your treatment. It also helps to make sure it's the most cost-effective option. When prior authorization is granted, it is typically for a specific length of time.
Prior authorization\u2014sometimes called precertification or prior approval\u2014is a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.
A pre-authorization is a restriction placed on certain medications, tests, or health services by your insurance company that requires your doctor to first check and be granted permission before your plan will cover the item.

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