Healthy Blue, an Anthem Company Nebraska Providers

Nebraska Providers

Prior Authorization Requirements


To request or check the status of a prior authorization request or decision for a particular plan member, access our Interactive Care Reviewer (ICR) tool via Availity. Once logged in, select Patient Registration | Authorizations & Referrals, then choose Authorizations or Auth/Referral Inquiry as appropriate.

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Behavioral Health

Fax all requests for services that require prior authorization to:


Inpatient:

844-462-0024

Outpatient:

844-462-0027

Prior authorization always required.

These behavioral health codes always require prior authorization:

0240–0249 All-inclusive ancillary psychiatric
0901, 0905–0907, 0913, 0917 Behavioral health treatment services
0944–0945 Other therapeutic services
0961 Psychiatric professional fees

Pharmacy

Prior authorization always required.

These pharmacy codes always require prior authorization:

0632 Pharmacy multiple sources

Related Information

Provider Tools & Resources