The peer-to-peer process* streamlines workflows, improves cost-efficiencies,
and complies with accreditation requirements. The process was developed with
input from the provider community and offers providers a streamlined process,
along with opportunities to discuss decisions and resolve inquires prior to
initiating a formal appeal.
Online submission
In order to process the peer-to-peer requests quickly and efficiently, be
sure to completely fill out the online peer-to-peer request form, which
includes:
- patient information (i.e., name, reference number/ ID number, and date of
birth);
- requesting physician?s contact information (i.e., name and telephone
number);
- inpatient information (i.e., facility name and telephone number, if
applicable).
Please note that an email address must be provided so we can contact you
with any questions to ensure your request is processed in a timely manner.
The peer-to-peer request form can be found on our website
.
Note: This information does not apply to providers contracted with
Magellan Healthcare, Inc., an independent company.
*Precertifications through AIM Specialty
Health® and CareCore National, LLC d/b/a eviCore healthcare,
independent companies, are not eligible for the peer-to-peer process.
Magellan Healthcare, Inc. manages mental health and
substance abuse benefits for most Independence Blue Cross members.