Prior Authorization The process by which a plan member or their doctor gets approval from their health plan before the member undergoes a course of care, such as a hospital admission or a complex diagnostic test. Also called preauthorization. Provider A licensed health care facility, program, ...
The way we review the type and amount of care you're getting. This involves looking at the setting for your care and its medical necessity. Examples may use prior authorization, case management, accompanying reviews or proper discharge planning. ...
Spring 2007 D&E WAIVER Presented by New Mexico Medicaid Utilization Review Blue Cross Blue Shield of New Mexico Prior Authorization Requests US Mail P.O. Box 27950 Albuquerque NM 87125-7950 Delivery Services (e.g., FedEx) 4373 Alexander Boulevard NE Albuquerque NM 87107 Hand-Carried ...