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.

Provider Initial
Authorization Form

Complete if you are a provider (therapist, social worker, psychiatrist) seeking initial treatment authorization for a patient.

Complete Online Form

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Outpatient Treatment
Authorization Form

Complete if you are a provider (therapist, social worker, psychiatrist) seeking additional treatment authorization for a patient.

Complete Online Form

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2019-2020 Year End
Transitional Form

Complete if you are a provider (therapist, social worker, psychiatrist) seeking continued authorization in 2020 for a patient in your care. 1/1/2020-2/29/2020 only

Complete Online Form

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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

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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

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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

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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

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 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.