At BCBSAZ Health Choice, our goal is to work closely with you and your practice team to streamline and expedite prior authorization. Many of the items on our abbreviated prior authorization list ask for notification only. Our centralized prior authorization center is designed to streamline processes resulting in timely expedited approval of prior authorization requests.
Prior Authorization Guidelines
Requests for services that require prior authorization can be submitted on the BCBSAZ Health Choice Prior Authorization form directly through the secure provider portal or via fax to the Authorizations department. All requests must include complete diagnosis and procedure codes, and the accompanying medical documentation (as needed).
In order to expedite prior authorization and provide quality services to our members, a contracted or preferred provider is recommended for all health care services for Health Choice members. Please note that all non-contracted providers must obtain authorization for any service. All out of state provider must have or be willing to obtain a valid and current AHCCCS ID number. AHCCCS-covered out of state care must be of an urgent or emergent nature.Prior Authorization Grid – effective 1/5/2024
Medication Prior Authorization Criteria
Submitting a Prior Authorization
- BCBSAZ Heath Choice Medical PA Phone: 1-800-322-8670
- BCBSAZ Heath Choice Medical PA Fax Line: 1-877-422-8120
- BCBSAZ Health Choice Medical Referral Fax Line: 1-855-432-2494
- BCBSAZ Health Choice Pharmacy PA Fax Line: 877-422-8130
BHIF, BHRF, TFC, and SUD BHRF Prior Authorization and Continued Stay Request Form
Notification of Admission, Transfer and Discharge for Out of Home Placements
Click here to access Prior Authorization Forms.
You can also view the status of previously submitted requests on the Provider Portal.
Dental Services Prior Authorization
BCBSAZ Health Choice requires all non-contracted dentists to obtain a Prior Authorization before rendering treatment. Please complete the Dental Specialty Referral Request Form and fax to 480-350-2217, email to: HCHdentaldeptHCA@azblue.com, or mail to:
BCBSAZ Health Choice, Inc.
Attn: HC Dental Prior Authorization
8220 N. 23rd Ave.
Phoenix, AZ 85021
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, contact EviCore by:
Provider Portal: https://www.evicore.com/pages/providerlogin.aspx
To check the status of a prior authorization request or to view more information, sign in to the provider portal.
Prior Authorization Grid – effective 1/5/2024
Prior Authorization Grid – effective 11/15/2023
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 11/05/2022
Prior Authorization Grid – effective 4/1/2022
Log on to the eviCore Provider Portal for all your radiology prior authorization needs.