Precertification and Prior-Authorization

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Need to create a new pre-certification request for your patient or to view the status of an existing pre-certification request?
Visit the secure pre-certification section.

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Members of some group health plans may have terms of coverage or benefits that differ from the information presented here.  The following information describes the general policies of Blue Cross and Blue Shield of Kansas (BCBSKS) and is provided for reference only.  This information is NOT to be relied upon as prior-authorization or precertification for health care services and is NOT a guarantee of payment.  To verify coverage or benefits or determine pre-certification or preauthorization requirements for a particular member, call 800-676-BLUE or send an electronic inquiry through your established connection with your local Blue Plan.


Pre-certification / Preauthorization information for out-of-area members

To view the out-of-area Blue Plan's general pre-certification/preauthorization information, enter the first three letters of the member's identification number on the Blue Cross Blue Shield ID card, and click "GO."

Type of information being requested

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If you experience difficulties or need additional information, please contact 800-676-BLUE.


Pre-certification required

Disclaimer: Some employer groups have some specific items that require prior authorization. Call for more information.


Predetermination/Prior-authorization required

Please complete and fax the BCBSKS predetermination or prior authorization form embedded within each policy below:

All other drugs may be prior authorized electronically by completing the prior authorization form through CoverMyMeds. If you need medical policies for these drugs, you will find a list below the CoverMyMeds form.


Many of our pharmacy medical policies are now being maintained through our pharmacy benefit manager, Prime Therapeutics.

To find pharmacy medical policies specific to a medication list, use the links below.

Policies may be temporarily housed here prior to being posted to the myprime.com website.