Tips & Tricks - Finding Your Form

• Align Mystical Filters
  • Insurance Type
  • Issuing State
  • Insurance Organization
    • Example View
• Example Member ID Cards 

Having trouble populating the form you are looking for? Try these tips and tricks in locating the appropriate form for your prior authorization.  

Align Mystical Filters

• When selecting options under "Patient Insurance Information" use these tips to make the appropriate selections. 

Insurance Type

• For your insurance type, you will need to identify the plan type for the member. This may be listed on the member ID card, but may also be specific to the insurance organization listed.
  • For example, Aetna Better Health is the Medicaid plan for Aetna. To populate forms for Aetna Better Health, you would select "Medicaid" as your Insurance Type, "Aetna" as your insurance Organization and the corresponding state listed on the member ID card for your Issuing State. 

Issuing State

• If a plan is state specific (i.e. Anthem, Molina) select the correct issuing state for the insurance plan. This information should be on the member ID card. The state may not always align with the resident state of the member. If a plan is not state specific (i.e. Cigna/Aetna), select the resident state of the member. 

Insurance Organization

• Select the main payer name directly from the member ID card. For example, Ambetter is a health insurance marketplace which provides different plan types for different states, and each state has a specific payer through Ambetter. For Texas, the member ID card will show "Ambetter from Superior Healthplan", so the issuing state would be Texas and the Insurance Organization would be Superior Healthplan.
  • Blue Cross Blue Shield member ID cards will provide an alpha numeric prefix, which will provide you with the appropriate BCBS payer and state. Ensure you are selecting the corresponding state and insurance organization matching the information provided form the prefix. You can search your prefix HERE to ensure the correct information is selected and the applicable form populates. 

Example View

BCBS View

Example Member ID Cards 

• Ambetter from Superior Healthplan
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• Blue Cross Blue Shield
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• Aetna Better Health of Kentucky
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We're here to guide you through your prior authorization quest!