CommercialPrior AuthHigh impact
December 2024 Quarterly Provider Insights
Blue Cross Blue Shield of North Dakota·ND·Provider News
Effective date
Dec 9, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of North Dakota implemented a new medical pharmacy prior authorization process effective December 9, 2024, requiring providers to use www.gatewaypa.com for clinician-administered drug prior authorizations. Additionally, faxed prior authorization requests will be cancelled starting January 1, 2025, with limited exceptions requiring electronic submission through Availity.
Action Required
Immediately: Begin using www.gatewaypa.com for all clinician-administered drug prior authorization requests for Commercial and Health Insurance Marketplace members. By January 1, 2025: Stop sending faxed prior authorization requests and use electronic submission through Availity/Predictal only. Exceptions allowed only with Availity ticket number for technical issues, Medicaid Expansion inpatient discharge notifications, or during system downtime. Train staff on new workflows to avoid authorization cancellations and claim denials.