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New Pre-Existing Condition Medical Information Request Form

As part of an ongoing effort to decrease the number of medical record requests made for claims reviewed for potentially pre-existing conditions and to increase provider and member satisfaction - Blue Cross and Blue Shield of North Carolina's (BCBSNC) Medical Review Department has implemented a new pre-existing condition medical information request form to all providers. The new form consists of three key questions that physicians can answer in lieu of sending us complete medical records for potential pre-existing conditions. This new process is effective as of July 1, 2009.

The pre-existing condition medical information request applies to all underwritten and ASO group members, as well as, individual members and State Health Plan members with pre-existing waiting periods. It does not apply to FEP, BlueCard or our Blue Medicare HMO and Blue Medicare PPO products.

The Medical Review Department will continually track the effectiveness of the new request form to ensure the process remains efficient, cost-effective and timely.