Medical Services That Need Pre-Approval
- Inpatient hospital admission
- Organ and tissue transplants
- Behavioral health (mental health and substance use disorder)
If you’re thinking about one of these services, have your doctor or provider call us at 1-800-222-4739 before you make your appointment.
Medications That Need Pre-Approval
Work with your provider to make sure you get your medications and prescription drugs pre-approved by Blue Cross NC before you buy them. Here's how:
- Visit https://www.fepblue.org/pharmacy
- Check your Service Benefit Plan Brochure
- Call 1-800-222-4739 or
- Call the Retail Pharmacy Program at 1-800-624-5060
Behavioral Health Services that Need Pre-Approval
Have your doctor or provider complete the form you need to request approval for mental health and substance use disorder services.
- Applied Behavioral Analysis / Adaptive Behavioral Treatment for Autism Spectrum Disorder
- Behavioral Health Care Length of Stay Extension
- Inpatient Psychiatric Care
- Residential Treatment Services
Your provider should submit the form by fax to 1-866-987-4159.