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Medical Association and Blue Cross and Blue Shield of Alabama Announce Patient Centered Enhancements to Prior Authorization Process
Effective date
Not stated in the notice
Identified
Nov 4, 2025
Summary
Blue Cross and Blue Shield of Alabama has implemented patient-centered enhancements to its prior authorization process, including elimination of AI-based denials, reduced repeat authorizations for chronic conditions, no reversal of approved services, expanded Gold Carding for trusted providers, online real-time approvals, 90-day prior auth portability between plans, and clearer transparency rules with 45-day notice for changes.
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What to do
Action · 6 steps
01Billing team and providers must review the new Gold Carding program eligibility criteria at BCBSAL and submit applications if your practice qualifies based on strong prior authorization approval history—this exempts you from standard prior authorization requirements for certain services.
02Update internal prior authorization tracking workflows to reflect that chronic condition medications/treatments will NOT require repeat prior authorizations once initially approved—document initial approval dates in billing system to avoid duplicate submission.
03Notify clinical staff that approved treatments/services will no longer be reversed if coverage remains active, eliminating need to resubmit authorizations due to coverage status concerns.
04Update patient communication materials to inform patients that if they switch BCBSAL plans, existing prior authorizations remain valid for 90 days for covered in-network services—billing team should verify prior auth validity before claim submission within this window.
05Monitor BCBSAL communications for the promised 45-day advance notice before any prior authorization rule changes and update billing system rules accordingly.
06Track implementation of the new electronic, real-time prior authorization platform and transition all prior auth requests to this system once available to eliminate manual processing delays.
If missed: Failure to adapt workflows may result in delayed approvals, unnecessary claim denials, and patient care disruptions.
Original notice
Medical Association and Blue Cross and Blue Shield of Alabama Announce Patient Centered Enhancements to Prior Authorization Process
mediacenter.bcbsal.org · Always check the source before changing claims.