Lisa Helbling: Chair and Consumer Director | Blue Cross Blue Shield of North Dakota
Lisa Helbling: Chair and Consumer Director | Blue Cross Blue Shield of North Dakota
Blue Cross Blue Shield of North Dakota (BCBSND) has joined a nationwide initiative to simplify the prior authorization process in health care. The company, along with other Blue Cross and Blue Shield entities, aims to make the process more efficient and accessible.
“BCBSND’s participation in these commitments reflects our continued efforts to strengthen our members' and providers' experience,” said Dan Conrad, BCBSND President and CEO. “In fact, BCBSND is already doing much of this work today. As an ongoing strategic priority, we are positioned well to meet or exceed the standards outlined in these national commitments.”
BCBSND has streamlined its processes by reducing the services requiring authorization to about 50. Providers can manage requests electronically and verify authorizations through an online tool. Most requests are processed within one business day with responses typically given within 48 hours.
The company is committing to several initiatives including standardizing provider submissions for electronic prior authorization and reducing prior authorization use for certain in-network services by 2026. It will also honor previous authorizations during a transition period when members switch insurance companies.
Additionally, BCBSND plans to make communications about prior authorization clearer and ensure that licensed physicians lead reviews of unapproved requests.
These improvements aim to create a more efficient healthcare system that benefits patients by ensuring effective care at lower costs.
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