Medicare Advantage Prior Authorizations

October 6, 2022

Start a prior authorizations for Premera Medicare Advantage (MA) plans by submitting a request. You can do this several ways:

• Online: Access the prior authorization and referral tool through OneHealthPort or the Premera MA provider website.
• Fax: Fill out a request form located on our website and fax to 1- 866-809-1370.
• Email: Fill out a request form and email to: MABXUMPremera@bcbsm.com

A note about forms: If you’re not submitting your request online, make sure you’re filling out the correct form and attaching all clinical information that justifies the need for the service. There are different prior authorization and request forms:

• Prior authorization form – General prior authorization request for services
• Part B drug request form - Prior authorization request for Part B medications
• Request for Medicare prescription drug coverage determination – Requesting appeal of Premera denial of coverage for a prescription drug
• Long-term acute care hospital care management form – Prior approval for long-term acute care
• Skilled nursing facility (SNF) and Inpatient (IPR) assessment form – Prior authorization for SNF for inpatient admissions

Questions and assistance

The direct phone number to the Utilization Management (UM) department is 855-339-8127. You can call for any UM question, such as requesting prior authorization forms, checking on a prior authorization status, phoning in a request for authorization, or checking if a service requires prior authorization.

Escalation

• If you’re having any issues getting your request escalated by phone, ask to speak to the UM supervisor for Premera. This is the quickest way to escalate a prior authorization issue.
• You can also escalate an issue via email at MABXUMPremera@bcbsm.com.

The UM team is available for provider assistance 24/7 and automatically converts to the on-call nurse when the call center is closed. If you can’t get through after hours, the UM after hours direct number at 313-236-7836.

Back to News