Pre-Certification

The information presented here applies to most Blue Cross & Blue Shield of Mississippi Members, but there may be some differences based on each individual's health and wellness benefit plan. Members can access their benefit plan through the myBlue portal on www.bcbsms.com. Some forms below can be submitted online. Others are PDF documents in which you can enter the information, save it on your computer, print and fax the form according to the instructions. This page is separated into Medical Services and Prescription Medications.

Medical Services

Providers who need assistance may call these numbers between 8:00 a.m. and 4:30 p.m. central time, Monday through Friday.

Provider Service: 601-932-1122 or 1-800-257-5825
Utilization Management: 601-664-4597 or 1-800-841-9659

Forms

Outpatient and Professional Services
Durable Medical Equipment
Inpatient Services
Home Health & Hospice Care
Home Infusion Therapy
Medical Transport
Mental Health and Substance Abuse [online form]
Solid Organ and Tissue Transplant
Treating Tobacco Use and Dependence Instructions

Maternity - If a maternity stay is expected to extend beyond 48 hours for vaginal delivery or 96 hours for caesarian section delivery, the Physician must request the additional days in order for the Company to determine the Medical Necessity. The Inpatient Medical-Surgical Services form may be used.

Hospice benefits require a Network Physician’s life expectancy certification

Solid Organ and Tissue Transplant require precertification. Please contact us at the phone numbers above.

Prescription Medications

Providers with questions should contact the Prescription Drug Service Team by phone at 601-664-4998 or 1-800-551-5258, 8:00 a.m. to 4:30 p.m. central time, Monday through Friday.

Prescription Drug benefits can vary depending on your patient's benefit plan. Members' financial responsibility may be either a co-payment or co-insurance amount. Members should refer to their Benefit Plan for their specific out-of-pocket expense responsibility. Certain drugs must be prior authorized by Blue Cross & Blue Shield of Mississippi, and dispensed by a Network Provider to be covered.

Physicians are responsible for submitting a prior authorization request directly to Blue Cross & Blue Shield of Mississippi for approval.

Click here to begin a Prescription Drug Prior Authorization Request