Inpatient Medical/Surgical Care Coordination
Please start the care coordination process by providing the provider and patient information. Once you have completed and submitted the necessary clinical information, Blue Cross & Blue Shield of Mississippi will communicate with your regarding the member's plan of care or if we need more information.
All fields indicated with an asterisk(*) are required for submission.
The Provider ID you have entered is identified as a Network Provider. Network Providers must issue inpatient pre-certification requests through myBlue Provider (http://www.myaccessblue.com).
Provider Information
*
Servicing Facility NPI
*
Billing NPI
Referring Provider NPI
Admitting Physician NPI
Check here if Medicare is primary and benefits exhausted
Patient Information
*
BCBSMS Subscriber ID
*
Subscriber's ZIP Code
*
Patient's Last Name
*
Patient's Date of Birth
Newborn Patient
YES
NO