BlueApprovR is an online tool accessible in Availity Essentials that allows providers to submit inpatient and/or outpatient prior authorization requests for medical/surgical, specialty pharmacy drugs, and behavioral health services, as well as recommended clinical review (RCR) requests for medical/surgical and specialty pharmacy drugs for many BCBSNM commercial members. 

BlueApprovR is designed to help simplify the provider submission process by asking for the information to support a medical necessity determination.

Registered Availity Essentials users have free, 24/7 access to BlueApprovR tool to:

  • Secure real-time approvals for certain services and begin treatment right away
  • Easily attach medical records
  • Check approval status and view history of your request

Use BlueApprovR to request prior authorization for these types of care:

  • Specialty Pharmacy
  • Behavioral Health
  • Inpatient Acute Care
  • Long-term Acute Care
  • Inpatient Rehab
  • Skilled Nursing Facility
  • Outpatient Hospice
  • Inpatient Hospice
  • Home Health
  • Outpatient Service

How to Access BlueApprovR:

1.     Log into Availity Essentials

2.     Select Payer Spaces from the navigation menu and choose BCBSNM

3.     Within Payer Spaces, select the Applications tab and click BlueApprovR

4.     Users will be redirected to BlueApprovR to complete the request online

Resources and Support:

Note: This new tool is currently not available for Medicare Advantage, Blue Cross Community CentennialSM or Federal Employee Program® (FEP®) members. Please use your existing process for requesting prior authorization for these members.

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSNM. BCBSNM makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.