Learn about medical management and evidence-based coverage criteria here. See medical and behavioral health policies. See current prior authorization and notification requirements. Use our prior authorization lookup tool.
About medical and behavioral health policies
The Blue Cross and Blue Shield of Minnesota (Blue Cross) medical and behavioral health policy team develops evidence-based medical and behavioral health policies. The team presents medical and behavioral health policies to the Blue Cross Medical and Behavioral Health Policy Committee and the Blue Cross Medical Pharmacy & Therapeutics Committee, which are made up of practicing physicians, pharmacists and other providers representing a variety of specialties and Blue Cross representatives.
See medical and behavioral health policies
About prior authorization
Blue Cross requires prior authorization (PA) for some covered admissions, continued stays, services, procedures, drugs and medical devices before they’re covered.
Prior authorization is a review and approval before a service happens to determine whether it’s medically necessary and appropriate. Prior authorization needs vary by the type of health plan the member has.
Questions about a medical policy or an appeal?
Providers: Please call provider service at (651) 662-5000 or 1-800-262-0820.
Members: Please call the number on the back of your member ID card or (651) 662-8000 or 1-800-382-2000 (TTY 711) or send a secure message to customer service after you log in to your member site.