All PlansAdministrativeMedium impact
MAPAP305 -Advanced Imaging Pre/Post Service Reconsideration Process - Direct to Blue Cross of Idaho for Reconsiderations
Blue Cross of Idaho·ID · Radiology, Diagnostic Imaging, Orthopedics +2 more·Medical Policy
Effective date
Jul 1, 2025
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho revised their advanced imaging reconsideration process, directing providers to contact Blue Cross directly (not Carelon) for prior authorization appeals. The policy clarifies different timelines and procedures for pre-service reconsiderations (14 days) versus post-service reviews (7 days).
Action Required
Immediately: Update advanced imaging prior authorization appeal procedures. When Carelon denies imaging prior auth, contact Blue Cross of Idaho directly at 1-888-494-2583 for reconsiderations instead of going through Carelon. Train staff on new timelines: 14 days to respond to information requests for pre-service appeals, 7 days for post-service documentation requests. Update workflow documentation and staff training materials.