BCBS AFFILIATEMSPBM: CVS Caremark

Blue Cross Blue Shield of Mississippi Prior Authorization Guide

Submit prior authorization requests and appeal denials with BCBS Mississippi. Phone numbers, fax numbers, appeal deadlines, step therapy override rights, and clinical documentation tips for MS providers.

Generate BCBS Mississippi LMN →

Prior Authorization Contacts

PA PHONE

1-800-222-8046

PA FAX

1-601-932-0702

TURNAROUND

30 days standard, 72h expedited

TIMELY FILING

90 days

APPEALS MAILING ADDRESS

BCBS Mississippi, Attn: Member Services, PO Box 1043, Jackson, MS 39215

Common Denial Reasons

⚠ BCBS MS Medical Policy criteria not met
⚠ Step therapy required
⚠ Non-formulary without exception request
⚠ Quantity limit exceeded

Step Therapy Requirements & Override Rights

Mississippi passed HB 495 (2022) establishing step therapy override requirements. BCBS Mississippi must respond within 72 hours. For biologics, typically requires conventional DMARD trial for RA or phototherapy for psoriasis.

Tips for BCBS Mississippi Submissions

1. Mississippi HB 495 provides step therapy override rights
2. CVS Caremark handles pharmacy benefit — use CoverMyMeds
3. Submit via BCBS MS provider portal
4. Reference BCBS MS Medical Policy number in LMN

External Review Authority

If BCBS Mississippi denies your final internal appeal, you have the right to request an external review through: Mississippi Insurance Department.

External review decisions are binding on the insurer.