HealthCare News

Precertification Process

Issue: #405 DEC2018

Topic: Education


Blue Cross Blue Shield of North Dakota (BCBSND) has recently seen an increase in incomplete precertification requests. Many forms do not have necessary information needed to process the request, such as CPT codes, diagnosis codes, provider NPI, etc. Providers should make sure they have correct contact information in the event BCBSND needs to clarify anything submitted on the form. To avoid delays in processing these requests, the form must be filled out in its entirety and all relevant clinical information provided.

To request Precertification, providers should use one of the following forms found on the BCBSND website (https://www.bcbsnd.com/web/providers/forms) under Precertification:

  • Inpatient Authorization Request
  • Outpatient Authorization Request
  • ABA Service for Autism Spectrum Disorder Request
  • APDS, CGM, Insulin Pump Supplement (also requires the Outpatient Authorization Request)

Procedure for submitting a precertification request to BCBSND:

  1. Complete the appropriate Precertification Request form
  2. Print a copy
  3. Save a copy for your records (electronic or hard copy)
  4. Send to BCBSND – follow instructions on the form
    • Fax to 701-277-2971
      Note: This fax line is used exclusively for the Utilization Management platform.
      Please use this fax number for Precertification Requests ONLY. OR
    • Mail to:
      4510 13th Ave South
      Attn: Utilization Management
      Fargo, ND 58121
  5. Once a decision has been made, BCBSND will send a fax notification of the determination to the fax number listed for the requesting provider on the Precertification Request form, which will be followed by a letter.