University of Rochester Employer Group Benefit Change Includes Courtesy Preauthorization
May 30th, 2025 | Payer Information•NewsWe would like you to be aware of a University of Rochester employer group benefit change effective April 2025. This change allows courtesy authorizations for services on Excellus’ current prior authorization list when obtained from the Accountable Health Partners (AHP) provider network, only.
Initiate a courtesy authorization request by calling the Excellus intake team at 1-800-363-4658.
The following services will remain subject to post-service medical necessity review for AHP providers if a courtesy preauthorization request is not completed:
- All in-network inpatient admissions (except maternity and emergency) and skilled nursing facility admissions
- Home health care
- Organ and tissue transplants
- Durable medical equipment over $200
- Services authorized through eviCore Healthcare (radiology, including MRA, MRI, PET and/or CT scans and nuclear medicine studies; cardiac services and devices; radiation therapy)
- Experimental/investigational services
Note: Medical specialty pharmacy services, including home infusion therapy, will remain subject to prior authorization requirements.
Preauthorization and concurrent medical necessity reviews remain applicable for services obtained from non-AHP providers.
Remember to check benefits and eligibility at Provider.ExcellusBCBS.com prior to delivering service to Excellus members.
Seeking courtesy authorizations for referrals to URMC specialists maximizes the chances of avoiding reimbursement issues on the back end.
