Prior Authorization & Clinical Guidelines
- Referrals
A referral is a written order from your primary care provider (PCP). In some situations, our plan or your PCP must give you a referral for you to get certain medical services from another provider in our plan.
You can get the services listed below without getting a referral from your PCP.
- Emergency care or urgently needed services
- Flu shots, COVID-19 vaccinations, Hepatitis B vaccinations, and pneumonia vaccinations
- Routine women’s health care includes breast exams, screening mammograms (x-rays of the breast), Pap tests, and pelvic exams as long as you get them from an in-network provider.
- In-network Specialist provider office visits do not require a referral, except for pain management services.
You can also get other kinds of care without a referral from your PCP (see Section 2.2 of Chapter 3 in your Evidence of Coverage).
Prior AuthorizationsSome medical tests or services require prior authorization before they are scheduled. Your provider requests prior authorization on your behalf. A prior authorization, commonly called a ‘PA’, is not a promise BCBSAZ Health Choice Pathway will cover the cost of the service.
A PA request is a form your provider fills out and sends to BCBSAZ Health Choice Pathway. Our prior authorization department will review the request and make a decision. A decision for a standard request is made within 14 calendar days and a decision for an expedited request is made within 3 calendar days. You and your provider will be notified if the service is approved or denied.
If you have a question about referrals and prior authorizations, Member Services can help you. Call us at 1-800-656-8991 (TTY 711). Our Member Services department is open 8 a.m. to 8 p.m., 7 days a week. You can also contact us by e-mail at HCHComments@azblue.com.
Prior Authorization Guidelines
- BCBSAZ Heath Choice Pathway Medical PA Phone: 1-800-656-8991, TTY: 711, 8 a.m. to 8 p.m., 7 days a week
- BCBSAZ Heath Choice Pathway Medical PA Fax Line: 1-877-424-5680
- BCBSAZ Health Choice Pharmacy PA Fax Line: 1-877-424-5690
- Click here to access Prior Authorization Forms
BCBSAZ Health Choice is partnered with EviCore for radiology benefits management of select MR, CT, PET, ultrasound and cardiac imaging studies.
To submit a new request for imaging services and select cardiac testing/procedures, providers may contact EviCore by:
Phone: 1-888-693-3211
Fax: 1-888-693-3210
Email: ClientServices@Evicore.com
Provider Portal: https://www.evicore.com/pages/providerlogin.aspxPrior Authorization Grid effective 2/1/2025
Prior Authorization Grid effective 1/5/24
Prior Authorization Grid Updates 11/15/23
Prior Authorization Grid effective 8/10/2023
Prior Authorization Grid effective 5/1/2023
Prior Authorization Grid effective 2/1/2023
Prior Authorization Grid effective 11/5/2022
Prior Authorization Grid effective 4/1/2022
Prior Authorization Grid effective 10/1/2021
Prior Authorization Grid effective 4/6/2021
Prior Authorization Guidelines effective 1/1/2021
Clinical Guidelines and Recommendations
Centers for Medicare and Medicaid Services – Medicare Coverage Database
BCBSAZ Health Choice Pathway utilizes:
- National Coverage Determinations (NCD)
- Local Coverage Determinations (LCD)
- InterQual
- UpToDate
- Oncology Clinical Practice Guidelines
- DrugDex AHFS (subscription required)
- Arizona Controlled Substance Prescription Drug Monitoring Program (login required)
Adult Hypertension Management Guidelines (NHLBI)
JNC 7 Report on Prevention, Detection, Evaluation and Treatment of High Blood PressureAdult Obesity Management Guidelines (NHLBI and NIDDKD)
Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in AdultsAsthma & COPD Management Guidelines (NHLBI)
Guidelines for the Diagnosis and Management of Asthma
COPD GuidelinesCardiac and CVA Care Management (ACC/AACE)
NCEP III GuidelineHIV Management Guidelines
CDC/NIHOpioid Safety
- CDC Clinical Practice Guidelines for Prescribing Opioids and Recommending Naloxone
- AZ Provider Resources such as coordinating care and using the Prescription Drug Monitoring Program