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Pre-service review for out-of-area members

The pre-service review for out-of-area members transaction allows PEAR Practice Management (PM) users to request pre-service reviews for out-of-area members by accessing the provider portal of the member’s home plan.

Please note that users may still need to call the member’s home plan to request preapproval if the home plan does not offer the pre-service review electronically.

To access the online pre-service review:

  1. Log on to Provider Engagement, Analytics & Reporting (PEAR) portal.
  2. Select PEAR PM.
  3. Select “BlueExchange® Out-of-area“ from the transactions menu. Then, select Pre-service for out of area members.
  4. Once the required information is entered, you’ll be able to access the provider portal of the member’s home plan and request preapproval.

Please see the BlueExchange® 101 guide on PEAR Help Center.