Utilization Management Resources   

Care Management Contact Information

High Tech Imaging Program

Utilization Management Guidelines (UMGs)

Commercial Prior Authorization Requirements

Musculoskeletal Program

Cite Guideline Transparency

Cite Guideline Quick Reference Guide

Commercial Radiation Oncology Therapy Program

Certain outpatient Radiation Oncology Therapy procedures will require prior authorization for some commercial members. You can verify member eligibility, benefit information and request a prior authorization for this BlueCross Radiation Oncology Therapy Program by logging in to Availity or by phone at 1-888-693-3211. You may also go directly to eviCore’s self-service web portal at www.evicore.com.

Commercial Radiation Oncology Therapy Program

BlueCross BlueShield of Tennessee Commercial Genetic Testing Program

Certain outpatient molecular and genomic tests will require prior authorizations for our Commercial fully-insured, individual and select self-funded members. Please note medical records may be required for the initial authorization review. You can verify member eligibility, benefit information and request a prior authorization for the BlueCross Genetic Testing UM Program by logging in to Availity^® or by phone at 1-888-693-3211. You may also go directly to eviCore’s self-service web portal at www.evicore.com.