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See Our Clinical Review Criteria Overview
BCBS Illinois·IL·Medical Policy
Effective date
Jan 22, 2026
We identified it
Jun 16, 2026
Summary
BCBS Illinois has released new training materials that provide an overview of clinical review criteria used for medical necessity reviews. This is an educational resource to help providers understand applicable medical policies and pharmacy guidelines for prior authorization and utilization management reviews.
Action Required
Optional: Review the new clinical review criteria training available through the BCBS Illinois provider portal to better understand medical necessity requirements for prior authorization requests. Access training through prior authorization support materials or webinars section.