Provider Section

Whether your an existing provider in our network looking for patient authorization or a new provider looking to join our network. We can assist you with getting you all the information you need.

Need benefit or claims information?

Contact our Provider Line at: 630-646-5370.

 

Provider Authorization Forms

BCP In-network Provider Forms only

If you are an out of network provider and have questions, please reference our Out of Network provider section below.

Initial Treatment
Authorization Form

Are you an in-network provider seeing a patient for the first time or is this the first time a different provider at your same office is seeing an existing patient? Let’s get their initial authorization started.

Complete Online Form

_____

Additional Treatment
Authorization Form

Are you an in-network provider with a patient who utilized most of the allotted initial sessions and find this member/family needs continued care? Let's get this additional authorization started.

Complete Online Form

_____

2020-2021 Year End Treatment Transition Authorization  Form

Are you an in-network provider who saw a patient in the previous year and they now have a session scheduled in the current year.  Let's transition this information from the previous year’s authorization.

Complete Online Form

_____

Psychiatrist Request for Mental Health Residential

Complete/fax this form if you are a psychiatrist seeking authorization for a patient who needs treatment in a residential mental health program

Complete Form

_____

Psychiatrist Request for Chemical Dependency (CD) Residential

Complete/fax this form if you are a psychiatrist seeking authorization for a patient who needs treatment in a residential CD program.

Complete Form

_____

Psychiatrist Request for
Psychological or Neurological Testing

Complete/fax this form if you are a psychiatrist seeking authorization for psychological testing or neurological testing.

Complete Form

_____

Psychiatrist Request for
Transcranial Magnetic Stimulation (TMS)

Complete/fax this form if you are a psychiatrist seeking Transcranial Magnetic Stimulation (TMS) treatment for a patient.

Complete Form

_____

 Out of Network Provider FAQ

 

I am an Out of Network provider, how do I get an authorization?

  • If you need help verifying if you are seeing a member of one of our managed plans, you can check which plans we manage on our Individual/Member FAQ or call our Provider Line to verify elegibility at 630-646-5370.
  • We do not provide authorizations for OON providers. Our members may have OON benefits but these are administered by their Health Plan and you will need to call them directly at the number listed on the back of the member’s card.

 

I am not in network but am interested in joining.