Tool removes the need for faxes and phone calls and is being utilized ~15,000 times a month
Part of a broader commitment to simplify health care
BOSTON, April 30, 2026 /PRNewswire/ -- Blue Cross Blue Shield of Massachusetts ("Blue Cross") today announced that the use of its new online preapproval tool has doubled in the past year, saving clinicians time and reducing administrative work. Blue Cross' Prior Authorization Quick Lookup tool has seen rapid provider adoption, climbing from roughly 7,300 interactions during the first month to averaging about 15,000 interactions currently.
Why it matters: The tool helps streamline administrative processes, eliminating the need for faxes and phone calls. With no registration or log-in required, it allows clinicians—particularly those who are out-of-state or out-of-network—to instantly check if a prior authorization is required for a service or to check the status of a previously submitted request.
- Prior authorization is an important tool to manage health care costs and mitigate patient risk. Without prior authorization, health care premiums would increase. However, Blue Cross reserves prior authorization for limited cases: 98% of claims don't require prior authorization.
By the numbers: Since its launch in April 2025, the tool has been used by clinicians more than 184,000 times, demonstrating its value in making the process simpler and more transparent.
What they're saying:
- Sarah Iselin, Blue Cross' CEO & president: "We're stewards of our members' premiums, with responsibility to ensure every dollar goes to care that is affordable, high-quality and effective. This tool helps us partner efficiently with clinicians in our network, so our members get the care they need as quickly and seamlessly as possible."
- Dr. Sandhya Rao, Blue Cross' chief medical officer: "We're focused on streamlining the prior authorization process wherever we can, and this tool's explosive growth shows it is solving a real-world problem for the clinical community. By providing a fast and transparent digital resource, we are helping our provider partners reduce their administrative workload so they can focus on what they do best: caring for our members."
How it works: Clinicians can use the tool to determine if an outpatient service, item, or provider-administered medication requires authorization or to check the status of an authorization or referral already requested for a specific member.
Blue Cross' commitment: The launch of this tool builds on our commitment to simplify processes related to the approval of health care services. Some recent highlights include:
- In 2025, we removed 88 prior authorization codes, estimated at 4,789 authorizations per year.
- In January 2024, we removed prior authorization requirements for home care services for commercial members – eliminating 14,000+ authorizations from the health care system.
- In September 2024, we removed prior authorization requirements for habilitation services for commercial members – eliminating about 13,000 authorizations from the health care system.
- In December 2023, we removed prior authorization requirements for other conditions including continuous glucose monitoring devices and supplies for Type 1 diabetes.
- We were a leader nationally in removing prior authorization requirements for outpatient mental health treatment and transfers from the emergency department to inpatient mental health stays.
About Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Massachusetts (bluecrossma.org) is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We are committed to showing up for everyone like they're the only one and guiding our members to the exceptional health care they deserve – affordably, equitably and seamlessly. In keeping with our commitment, we are rated among the nation's best health plans for member satisfaction and quality. Connect with us on Facebook, Instagram, and LinkedIn.
SOURCE Blue Cross Blue Shield of Massachusetts