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Authorizations
Prior authorization is the requirement that a physician or other qualified provider obtain approval from Blue Shield before prescribing a specific medication, procedure and/or service.
Authorization tools | Managing out-of-area Blue plan members | Clinical policies & guidelines | Prior authorization forms & list | Additional resources
Authorization tools

Blue Shield providers can submit medical and pharmacy authorizations online in AuthAccel. Blue Shield Promise providers can submit medical authorizations online, but pharmacy requests must faxed.

The status of all medical and pharmacy requests can be viewed in AuthAccel for both Blue Shield and Blue Shield Promise members, regardless of how they are submitted.

Below are instructions for using AuthAccel.

Request a medical authorization (PDF, 329 KB)

View medical authorization status (PDF, 272 KB)

Request a pharmacy authorization (PDF, 251 KB)

View pharmacy authorization request (PDF, 177 KB)

AuthAccel frequently asked questions (PDF, 277 KB)

Authorization basics for providers
Learn how to submit medical and pharmacy authorization requests.
Is authorization required for a Blue Shield of California member?
See if medical service requires prior authorization.
Request medical authorization
Submit your medical requests online via AuthAccel.
View medical authorization status
Check the status of medical authorization requests you’ve submitted.
Request pharmacy authorization for Blue Shield members
Submit your pharmacy requests online via AuthAccel.
View pharmacy authorization status
Check the status of pharmacy authorization requests you've submitted.
Request pharmacy prior authorization electronically
Submit requests with CoverMyMeds®, an electronic prior authorization provider.
Request pharmacy prior authorization electronically
Submit requests with Surescripts®, an electronic prior authorization provider.
Managing out-of-area Blue plan members

Find tools, information, and resources to assist you in serving your patients insured by other state Blue plans.

Pre-service review
Access online tools to verify medical policy, determine pre-service requirements, request authorization.
BlueCard Program
Find information and tools you need to serve patients covered by other Blue plans.
Clinical policies and guidelines

Find policy information about medications and medical procedures, devices and technologies, learn about our prior authorization procedures, and access our outpatient drug formulary.

Drug formularies & policies
Search drug formulary database and find policy info on oral, topical and home-injectable drugs.
Medical policies & procedures
Learn about our medical policies, policy goals and new technologies coverage decisions process.
Medication policy
Read about our medication policies for Medicare and Commercial members.
Policy & prior authorizations for out-of-state members
Find medical policy and general prior authorization requirements.
Prior authorization forms and list

View, download and print authorization fax forms for medical services and injectable, oral, and topical drugs. Learn what medical services need authorization and where to obtain it.

Prior authorization forms for Blue Shield members
Download and print prior authorization forms for procedures and drugs.

Prior authorization list for Blue Shield (including Medicare 65+) and FEP members
Search a list of medical services and procedures requiring prior authorization.

Prior authorization forms for Blue Shield Promise members
Download prior authorization forms for procedures and drugs.

Prior authorization list for Blue Shield Promise members
Search a list of medical services and procedures requiring prior authorization.
Additional resources

Learn to use AuthAccel and find out who to contact if you have questions about prior authorizations.

AuthAccel training & info
Learn to use AuthAccel, Blue Shield's online prior authorization system.
Authorizations contacts
See phone numbers, addresses, and more.

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