Prior Authorization for Outpatient and Professional Services

Please start the request by providing the following provider and patient information. Once you have completed and submitted the request, Blue Cross & Blue Shield of Mississippi will communicate with you by email if we need more information or when we reach a decision on your request.

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 prior authorization requests through myBlue Provider (http://www.myaccessblue.com).

Patient Information

*BCBSMS Subscriber ID

*Subscriber's ZIP Code: *Patient's Last Name: *Patient's Date of Birth: