Dear Providers,
BCBSNC has informed HNS that the outstanding issues with accessing the Carelon online prior authorization (PA) portal have been resolved and that the new effective date of the program is for dates of service on or after 12/1/2024.
At this time, you should be able to access the Carelon portal through your Blue E account and will be able to begin submitting PA requests for physical therapy (PT) services for fully insured BCBSNC members when required. Please note, however, that requests cannot be submitted more than 30 days in advance of the first treatment visit requiring PA.
Registration instructions for Blue E, how to access Carelon’s online portal through Blue E, the timeframes for submitting PA requests, and other helpful updates have been added to HNS’ BCBSNC Physical Therapy Prior Authorization Summary Sheet, linked below.
the Most Recent Version of the
BCBSNC Physical Therapy Authorization Summary Sheet
To help ensure that you properly login to the PA portal, please carefully review Section 1 in this document in its entirety before accessing the portal the first time.
Moreover, to properly obtain PA and avoid denials, please be sure you and your billing CA thoroughly understand this new PA program and follow all directions included in this document.
HNS will continue to update the BCBSNC Physical Therapy Prior Authorization Summary Sheet, as well as the BCBS-Carelon section of the HNS website, with any additional important information we learn about the BCBS PA program, and will also notify the network of any pertinent updates.
Sincerely,
HNS