June 2025

Best practices for prior authorization requests with InterQual Connect questions in e-referral system

After answering InterQual Connect questions in the e-referral system, do the following to ensure prior authorization requests for Medicare Plus Blue℠, Blue Care Network commercial and BCN Advantage℠ members are processed as quickly as possible:

Always click Review Summary — Refer to Step 1 below for additional details.
Always click Complete to submit requests — The Save Review button has been renamed to Save For Later. Don’t click on the Save For Later button, as it will cause your request to pend even if criteria are met and will delay the processing of your request. Refer to Step 2 below.

Here’s what to do to submit a request after answering InterQual Connect questions in the e‑referral system:

On the Recommendations screen, do one of the following:

If…	Do this…
The recommended service is automatically selected. Tip: Look for a check mark to ensure the service is selected. See the image below for an example.	Click on Review Summary. Important: If you don’t select a recommended service, cases that meet criteria will pend for review. This will delay our processing of your request.
The recommended service is not automatically selected.	Select the service, and then click on Review Summary.
There is no recommendation.	Click on Review Summary.

A screenshot of a computer AI-generated content may be incorrect.

On the Review Summary screen, review the summary and click on Complete to submit the request.

Important: Don’t click on Save For Later. This will cause your request to pend even if criteria are met and will delay the processing of your request. Always click on Complete to submit the request.

A screenshot of a computer AI-generated content may be incorrect.

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