Your Blues Plan Says the Prior-Auth Phone Call Is Optional. Ask For Fax.

HCSC's five Blue Cross plans moved ABA prior authorizations onto scheduled live calls in April. By June the calls were jamming. The plan told Behavioral Health Business the calls are not mandatory — which is the part most providers have not been told.

Health Care Service Corp. — the independent licensee operating Blue Cross Blue Shield in Illinois, Montana, New Mexico, Oklahoma and Texas — now handles ABA prior authorizations through a system of scheduled live phone calls. Announced at the start of the year, it rolled out in April, took hold through May, and by June had become, in the words of providers who spoke to Behavioral Health Business anonymously for fear of retribution, "fraught with delays, creating insurmountable bottlenecks."

The turn is in the plan's own response. An HCSC representative told BHB that the phone-call process is not mandatory and that providers still may use faxes. If your intake staff have been queuing for schedulers since April believing the call is the only route, that is a change you can make this week without anyone's permission.

How the process actually runs

  • You call a scheduler to set up a later call with a case manager.
  • Providers describe delays reaching schedulers at all, then case-manager slots set several days out from the scheduling call.
  • In some cases schedulers call clinics back saying they have a 48-hour window to reach the case manager or the authorization will be denied.
  • On the call, case managers walk through material already submitted. "A lot of times what you're doing is you're redoing the work that you've already done," a billing service professional told BHB.
  • Each call pulls in clinicians, not just administrators, because the clinical elements have to be discussed by someone who can discuss them.

A provider manager put the objection plainly: the authorization forms are five pages, every field required, and they have always carried the treatment-plan detail. "It's always been like that, and it's never been an issue… Why are we changing it now when we're pretty much [discussing] every single question, every single field on that form?"

What the plan says

HCSC's position is that this is an improvement, not a gate. "We think this is an enhancement to the provider experience and intend to make it permanent," the representative said. "The goal of this process is to improve the provider experience and help members get care faster."

On the denials, the plan told BHB it is required to decide prior authorizations in keeping with regulatory and accreditation standards, and may determine there is not enough information to assess medical necessity if providers are not appropriately responsive. Read that alongside the 48-hour window: unresponsiveness and unreachability are being treated as the same thing, and only one of them is yours to fix.

The limits

Nobody outside HCSC knows why this happened. Industry sources speculated to BHB about fraud prevention, a systems transfer, or a measure to slow ABA spending generally — speculation the reporting labels as speculation, and we will not upgrade it. What is documented is the mechanism, the timing and the plan's own statement that fax remains open.

Scale matters for how hard this lands: HCSC generated $66.8 billion in revenue in 2025, employs about 37,000 people and engages 27 million members. In markets thick with HCSC members, this is not one payer's paperwork — it is most of your intake.

What you must know or do

  • Owners and intake leads, this week: pull every ABA authorization you have pending with BCBS of Illinois, Montana, New Mexico, Oklahoma or Texas. For each one waiting on a scheduler or a case-manager slot, submit by fax instead and note the date you did. HCSC has said on the record that fax is still available; you are not asking for an exception.
  • Log the ultimatums. If a scheduler gives your clinic a 48-hour window, record the call date, the name, the window given and the authorization number. A denial for non-responsiveness is appealable, and the appeal is only as good as the record of who was unreachable first.
  • Stop sending clinicians to restate the form. If a live call is genuinely required for a specific case, send the person who filled the form in. Billable clinician hours spent reading a submitted document aloud are the real cost here, and they do not appear on any payer's ledger.
  • Check your exposure before the next authorization cycle. Count what share of your active authorizations sit with these five plans. If it is above a third, the fax route is not a workaround — it is your standard operating procedure until HCSC says otherwise.