Prior Authorization

A service or medication may require a prior authorization based on your patient’s plan. You can request an electronic prior authorization by continuing below. Please note that a Blue KC provider portal account is required for submitting and reviewing prior authorizations.

Review or Submit Prior Authorizations

Fax, Mailing, and Prior Authorization eForms In Requests

You may also submit requests by fax, mail or prior auth eForms. Please include any supporting medical information in your request. Check the status of an existing request using the customer service number listed on the member ID card.

Commercial, FEP, JAA Plan eForms

Commercial Blue KC Prior Authorization Forms - Medical Services, Procedures, and Equipment
Commercial Blue KC Prior Authorization Forms - Medications (covered under Medical benefits)
Commercial Blue KC Prior Authorization Forms - Medications (covered under Pharmacy benefits)

ACA Prefixes: YBD, YBG, YBS, YBM, YBT, YBX, YJV, YJW, YJJ or YJT

ACA Plan eForms
ACA Blue KC Prior Authorization Form - Medical Services, Procedures, and Equipment
ACA Blue KC Prior Authorization Form - Medications (covered under Medical benefits)
ACA Blue KC Prior Authorization Form - Medications (covered under Pharmacy benefits)

ACA PDF Forms
ACA Blue KC Prior Authorization Form - Medical Services, Procedures, and Equipment
ACA Blue KC Prior Authorization Form - Medications (covered under Medical benefits)
Radiology Services

Commercial, ACA, FEP, and JAA Plans Medical Service, Procedure, or Equipment Fax Requests:
(816) 926 - 4253

ACA Plan Member Medication (Medical Benefit) Fax Requests:
(816) 995 - 1597

Commercial, ACA, FEP, and JAA Plans Mail-In Requests:
Blue Cross and Blue Shield of Kansas City
Attention: Prior Authorization, Mail Stop B5A1
P.O. Box 411878
Kansas City, MO 64141-1878

MA Prefixes: RRK or RKN

MA eForms
MA Blue KC Prior Authorization Form - Medical Services, Procedures, and Equipment
MA Blue KC Prior Authorization Form - Part B Medications
MA Blue KC Prior Authorization Form - Part D Medications

MA PDF Forms
MA Blue KC Prior Authorization Form - Medical Services, Procedures, and Equipment
MA Blue KC Prior Authorization Form - Part B Medications
Radiology Services

MA Plan Members Medical Service, Procedure, or Equipment Fax Requests:
(877) 549 - 1744

MA Plan Member Part B Medication Fax Requests:
(816) 398 - 6547

MA Plan Members Medical Service, Procedure, or Equipment Mail-in Requests:
Central Operations (COPS) Blue KC MA & ACA
P.O. Box 419169
Kansas City, MO 64141

Prior Authorization

Blue KC Provider Portal for Prior Authorization Requests will be offline from July 26th at 9 p.m. to July 29th at 7 a.m. Please see the applicable fax numbers below if needing to submit a request during this time.

Commercial Plan Members Medical Service, Procedure, or Equipment:
(816) 926-4253
Prior Authorization General Request for Elective Surgery, Procedure, Service or DME Form – Please Print and Fax

Commercial Plan Members Medication:
(816) 926-4253
Prior Authorization Medications – Please Print and Fax

MA Plan Member Part B Medications:
(816) 398-6547
Part B Drug Prior Authorization Request Form – Please Print and Fax

MA/ACA Plan Members Medical Service, Procedure, or Equipment:
(877) 549-1744
MA Prior Authorization General Request for Elective Surgery, Procedure, Service or DME – Please Print and Fax
ACA Prior Authorization General Request for Elective Surgery, Procedure, Service or DME – Please Print and Fax

ACA Plan Member Medications:
(816) 995-1597
Medical Drug Prior Authorization Request Form – Please Print and Fax