Behavioral Health Inpatient Prior Authorization IVR Caller Guide Form

1) Getting Started Welcome to the Blue Cross Blue Shield Behavioral Health Services. Para asistencia en español, oprima siete. Yes No Press 1 Press 2 Interruption Permitted First, if you’re a member in a crisis or a true-life threatening situation say “yes” or press 1. All other callers please remain on the line. For information in English, please stay on the line for assistance. Interruption Permitted To direct your call please say one of the following, “Provider” or “Member.” Provider Member Press 1 Press 2 Interruption Permitted Okay. If you know your party's extension, say “extension.” Say “Extension” or remain silent if you do not have one. Note: You can use your touch tone keypad to enter numeric information. Say or enter your NPI or 3-digit HMO site number. In order to get eligibility or benefits we’ll need your rendering NPI or HMO site number. For claims or any other inquiries, we’ll need your billing NPI. Now what is your 10-digit NPI or HMO site number? Interruption Permitted Situational: If the system does not recognize the NPI, you will be prompted for a Tax ID. Blue Cross and Blue Shield of Oklahoma, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association 800-672-2378 • Utilize your key pad when possible Hours of Availability: Monday – Friday 6:00 a.m. to 11:30 p.m. (CT); Saturday 6:00 a.m. to 6:00 p.m. (CT); Sunday – Closed Behavioral Health Inpatient Authorization IVR Caller Guide • Utilize your keypad when possible • Avoid using cell phones • Minimize background noise • Mute your phone when you are not speaking 1 of 3 September 2024 This caller guide does not apply to Medicare Advantage members.

Say or enter only the subscriber ID, excluding the three-character prefix. Note: Alpha and numeric characters may be entered by touch tone keypad. The Alpha Touch Tone reference guide is available on page three for assistance with keying alpha characters. Interruption Permitted Okay. Authorization and referral management. Excluding the three- character prefix, what’s the subscriber ID? Situational: If multiple policies are found for your patient, you will be asked to provide their group number. Interruption Permitted That’s 123456789. Is that correct? Yes No Press 1 Press 2 Medical Behavioral Health Chemical Dependency Press 1 Press 2 Press 3 Interruption Permitted Is this for medical, behavioral health or chemical dependency services? Interruption Permitted Thanks, I’ll just look that up. Which can I help you with eligibility and benefits, claims, authorization and referral management, or other services? Eligibility and Benefits Claims Authorization and Referral Management Other Services
Press 1 Press 2 Press 3 Press 4 • Utilize your keypad when possible • Avoid using cell phones • Minimize background noise • Mute your phone when you are not speaking Interruption Permitted Please hold while I connect you. This call may be recorded. Remain on the line while you are being connected with a Behavioral Health Customer Advocate. Interruption Permitted Do you need to check procedure code requirements, request authorization and referral, or check the status? Interruption Permitted And do you want to create a new request or extend an existing request? New Request Extend Existing Request Press 1 Press 2 Interruption Permitted Okay. Inpatient, outpatient, home or referral? Inpatient Outpatient Home Referral Press 1 Press 2 Press 3 Press 4 Behavioral Health Inpatient Authorization IVR Caller Guide 2 of 3 2) Authorization and Referral Management Note: Use Availity® Essentials Authorizations to submit your requests online. Check Procedure Code Requirements Request Authorization and Referral Check the Status Press 1 Press 2 Press 3

• Avoid using cell phones • Minimize background noise • Mute your phone when you are not speaking • Utilize your keypad when possible • Avoid using cell phones • Minimize background noise • Mute your phone when you are not speaking Have questions or need additional education? Email our Provider Education Consultants. Be sure to include your name, direct contact information and Tax ID or Billing NPI. A B C = = = 21 22 23 D E F = = = 31 32 33 G H I = = = 41 42 43 J K L = = = 51 52 53 M N O = = = 61 62 63 P Q R S = = = = 71 72 73 74 T U V = = = 81 82 83 W X Y Z = = = = 91 92 93 94 Alpha Touch-Tone Reference Alpha touch-tone is available as an alternative to voicing alpha-numeric mixed information. To enter a subscriber ID, group or claim number containing alpha character(s): 1) Press the star key () to begin a letter sequence 2) Press the number key containing the desired letter (e.g., press 2 for A, B or C) 3) Press 1, 2, 3 or 4 to indicate the position the letter is listed on the selected key (e.g., press 21 to enter A) Note: Exclude three-character prefix when entering the subscriber ID. A 1 N 2 3 4 5 6 7 21 1 62 2 3 4 5 6 7 0 9 2 T 7 6 8 0 9 2 81 7 6 8 Ex. 1 Press Ex. 2 Press Y N 1 2 3 4 93 62 1 2 3 4 1 2 K 3 4 5 1 2 52 3 4 5 Ex. 1 Press Ex. 2 Press 2 1 3 4 F 5 6 7 0 X 2 1 3 4 33 5 6 7 0 92 2 0 1 T 8 7 6 5 0 C 2 0 1 81 8 7 6 5 0 23 Ex. 1 Press Ex. 2 Press Note: The claim number should be 13 digits. Group Number Subscriber ID Claim Number 3 of 3 Behavioral Health Inpatient Authorization IVR Caller Guide Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. Certain employer groups may require prior authorization or pre-notification through other vendors. If you have any questions, call the number on the member's ID card. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSOK. BCBSOK makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.