As part of its mission to help members access quality, affordable health care, Blue Cross and Blue Shield of Nebraska (BCBSNE) announced today a series of improvements to the prior authorization process. Alongside other national insurance providers, BCBSNE and other Blue Cross and Blue Shield companies announced six commitments that will make the process faster, more seamless and more streamlined.

“We are committed to helping our members access effective and affordable health care,” said Jeff Russell, BCBSNE’s president and CEO. “At the state level, we recently collaborated with the Nebraska Hospital Association and the Nebraska Medical Association on LB77, which will bring needed standardization to prior authorization processes. Now, at the national level, we join Blue Plans and other commercial health insurers to improve the prior authorization process for our members and provider partners. As a company committed to being a champion for the health and well-being of our members and the communities we serve, we are focused on making the health care system better for everyone.”

As part of today’s national announcement, BCBSNE is committing to:

  • Standardizing provider submissions for electronic prior authorization, giving doctors more time for patients by lessening administrative burden.
  • Further reducing the use of prior authorization for certain in-network medical services by 2026.
  • Ensuring a seamless process for members who switch health insurance companies by honoring their previous health insurance company’s prior authorization approvals for benefit-equivalent in-network services as part of a 90-day transition period, by 2026.
  • Making the process more transparent by ensuring our communications to members about prior authorization are clear and contain personalized information including what is needed to support approval, next steps and available appeal processes.
  • Fast-tracking responses for electronic prior authorization requests by committing to answering at least 80% of requests in near real-time in 2027.
  • Affirming that licensed physicians personally lead reviews of unapproved prior authorization requests.

Improving the prior authorization process will help us create an efficient, affordable and sustainable health care system for everyone. Working together, across health insurers and with care providers, we will ensure that patients receive the most effective care, at a more affordable cost.

For more information, go to the BCBS Prior Authorization webpage.