Prior Authorization
BJC HealthCare currently provides prior authorization services for the following:
- Family Medicine
- Gastroenterology
- Internal Medicine
- Neurology
- Neurosurgery
- Obstetrics and Gynecology
- Ophthalmology
- Orthopedics
- Orthopedic Surgery
- Otolaryngology (ENT)
- Pain Management
- Pediatrics
- Physical Medicine and Rehabilitation
- Pulmonology
- Radiation Oncology
- Surgery (with the exception of Oncology and Transplant Surgery)
All Washington University, BJC Medical Group and private practice providers whose primary specialty is listed above automatically receive prior authorization services.
Submit the order as you normally do. The BJC Pre-Arrival Team will complete the authorization process and contact your office if other information is required.
- MRI
- CT
- CT lung cancer screenings
- PET
- Nuclear medicine
- Interventional radiology
- CV Cardiac
- CV Echo
- CV Stress
- Sleep
- Neurology (EEG only)
- United HealthCare and Gateway to Better Health encounters
- Anything scheduled within two (2) business days of the visit is considered urgent and the referring provider is responsible for obtaining the authorization. (Hospitals currently offering same day/2 day prior authorization services will continue to do so.)
- Epic Providers: There will be some changes related to Epic referral flags which are used for notification of peer-to-peer, denial or the need for additional clinical information. HIP Tips and the Epic Training Team will be available to assist as needed.
- Non-Epic Providers: Workflows will not change.
Yes. Providers on Epic and EpicCare Link may view the BJC Pre-Arrival Team’s documentation in the “Notes” section of the referral.
BJC Pre-Arrival will be expanding the list of specialties covered in 2023. Check back for updates.