Prior Authorizations/Care Coordination

Healthcare Services

Blue Cross & Blue Shield of Mississippi (BCBSMS) requires prior authorization or care coordination for some healthcare services before they're covered. Please refer to our list of Healthcare Services Requiring Prior Authorization for more information. The most efficient way to submit and manage requests for prior authorization is through your secure myBlue Provider account. Visit Prior Authorization Reporting to review our annual prior authorization statistical report.

Healthcare Services Requiring Prior Authorizations

Prescription Drug Services

Prior authorization requests are used to help ensure the most cost-effective and medically necessary medication is used to help our Members. All Disease Specific Drugs must be prescribed by a Network Provider, prior authorized by BCBSMS, and dispensed by a Disease Specific Pharmacy or Non-Pharmacy Network Provider to be covered.

If you are a Network Provider, you are responsible for submitting a prior authorization request directly to BCBSMS for approval. Login to your myBlue Provider account to request a prior authorization. Go to Be RxSmart for more information about prior authorization for medication.

Out-of-State or Non-Network Providers

To view an out-of-state Blue Plans' medical policies or prior authorization/care coordination information, please select "Request Out-of-State Provider Information" below. You will need to enter the first three letters of the member's identification number on the Blue Cross and Blue Shield ID card.