Temporary Changes to Utilization Review Requirements
As a result of COVID-19, there is increased use of healthcare services and resources across the nation.Bright Health is focused on supporting our Care Partners and Providers in the care of our members to keep members safe. As a result, we are temporarily relaxing select authorization requirements for a cohort of services, effective as of March 1, 2020 and until further notice.
View our Temporary Changes to Utilization Review here. 

Billing Codes
To increase access to diagnostics and fight the spread of illness, we have updated our coverage policy to cover services obtained beginning the earlier of regulatory requirements or 3/1/2020. For more information, please visit Bright Health in the Payer Spaces area of Availity.com  and click on the “COVID-19 Billing Updates” document.

• General Information

  • Prior Authorization Instructions 

  • Submit form:
    For immediate confirmation and easy tracking, submit prior authorization requests online at Availity.com . Submission of prior authorization requests via phone or fax can be done using the contact information on the prior authorization forms.

  • Electronic Authorization Submission Resources:

    • Quick Guide 
    • User Guide 
    • Training Webinar 
    • Change Request Form Instructions 

• Individual and Family

  • Commercial Plans Prior Authorization List 
  • Medical Inpatient Form 
  • Medical Outpatient Form 
  • Behavioral Health Form 
  • Psychological/Neuropsych Form 
  • Substance Abuse Disorder Form 
  • Authorization Change Request Form 
  • Submit electronically via Availity.com 
  • Submit prior authorization request via fax: 1-833-903-1067
  • Submit inpatient concurrent review via fax: 1-833-903-1068
  • Utilization Management Program Phone: 1-844-990-0375

• Medicare Advantage

  • HMO Prior Authorization List 
  • Medical Inpatient Form 
  • Medical Outpatient Form  
  • Behavioral Health Form 
  • Psychological/Neuropsych Form 
  • Substance Abuse Disorder Form 
  • Authorization Change Request Form 
  • Submit electronically via Availity.com 
  • Submit prior authorization request via fax: 1-833-903-1067
  • Submit inpatient concurrent review via fax: 1-833-903-1068
  • Utilization Management Program Phone: 1-844-929-0162

• General Information
  • Forms and Documents
  • Provider Dispute Resolution 
  • Provider Liability Waiver 
  • Claims can be filed through Availity.com  for immediate confirmation and easy tracking
• Individual and Family
  • Forms and Documents
  • Registering for Payments 
  • File a claim:
    Bright Health Plan
    PO Box 16275
    Reading, PA 19612-6275
    Payer ID CB186
• Medicare Advantage
  • Forms and Documents
  • Registering for Payments 
  • Provider Refunded Check Form 
  • Submit refunded checks:
    Bright Health Plan
    Provider Refunds
    PO Box 853960
    Richardson, TX 75085-3960
  • File a Claim:
    Bright Health Medicare
    PO Box 853960
    Richardson, TX 75085-3960
    Payer ID BRT01

• General Information
  • Bright Health case management referrals can be submitted via phone or fax using the Case Management Referral Form.
• Individual and Family
  • Forms and Documents
  • Case Management Referral Form 
  • Request via phone: 1-888-658-6818
  • Submit via fax: 1-833-903-1607
• Medicare Advantage
  • Forms and Documents
  • Case Management Referral Form 
  • Request via phone: 1-888-668-0804
  • Submit via fax: 1-833-903-1607