Alberta Blue Cross Benefits Forms
Alberta Blue Cross (ABC) drug special authorization form(s) must be completed, submitted and approved in order for a patient to be eligible for medication health insurance coverage of a number of outpatient medications that may be supported by programs administered by ABC.
External (Blue Cross) Forms
All available ABC drug special authorization forms can be found via an online database maintained by ABC. Print-ready (PDF) forms can be downloaded, printed and completed by prescribers. The full set of forms, plus all related requirements and instructions, are available via:
Completed forms should be scanned, attached to the Connect Care chart as "Media" documents, and faxed to ABC. The process is time-consuming, involves re-entry of data already in Connect Care, and is error-prone.
Internal (Connect Care) Forms
Communication (Letter) "cForms" facilitate standardized documentation while accommodating a stakeholder's requirement for a particular documentation format. The forms are sent via automated fax, and are accepted by clinical drug services administered by ABC.
Many ABC drug forms are configured for semi-automated completion in Connect Care and direct digital transfer (via RightFax) to ABC.
Finding Blue Cross Internal (Connect Care) Forms
Chart Sidebar
The easiest way to find the digital Blue Cross drug authorization form is to use the chart sidebar (rightmost collapsible column available to charts opened in Emergency, Inpatient, Outpatient contexts):
Select the "Forms" link from the index (bottom of left column).
From the Forms Sidebar display that appears, select the link to "Approval Requests".
From the pop-up list of approval requests, select one of the links in the "INTERNAL" Blue Cross drug special authorization forms section. This will set up the appropriate form in the Communications activity.
Currently available Connect Care ABC forms can be found via an "Alphabetical Drug Listing" link.
A "General Purpose" ABC form link can be used if a specific drug form is not available (external or internal).
Authorization forms are also organized categorically, with a link for each of the major specialties needing such forms.
The alphabetical and categorical drug listings can be browsed (drugs are listed alphabetically) or searched (use the search icon [binoculars] with a drug brand or generic name of interest).
Consent and eForms Navigator
The Consent and eForms Navigator can be found via a link in the chart Storyboard (leftmost column in all charts), via the Activities menu, by using a link in the chart sidebar ("Forms" index entry, "eForms" link in the sidebar view that opens), or via the chart search tool.
Open the Consent and eForms Navigator.
Select the "Letter Forms" Navigator menu item (bottom of left column of navigator).
Select the "cForm Letters" link within the Letter Forms Navigator section to open a pop-up display. Alternately, select the "Sidebar" link to open access to ABC forms via the chart sidebar described above.
A pop-up display will include a list of available forms. Select the "Approval Requests" category.
A secondary pop-up will show available types of approval request forms. Select via an alphabetical or categorical listing within the "INTERNAL" ABC forms section, as described above.
Work with the Blue Cross form that appears in the Communications activity.
Communications Activity
The Communications activity can also be opened from within any chart opened to an inpatient, emergency or outpatient encounter.
Open a Communications activity (chart search for "communications", or use chart sidebar link from "Forms" sidebar, or find in Wrap-up (emergency and outpatient) navigators.
Start a new Communication, then use the "Replace Template" link to look for a specific communication template.
Search using "blue" and the drug name of interest in the template selector and choose an appropriate "BLUE CROSS..." template.
The special authorization form will be set up in the Communications activity.
Completing Blue Cross Forms
Interactive Charting
ABC Connect Care "internal" forms are built with templates that use interactive charting (e.g., click-to-review and click-to-edit for any text appears in a dark blue font colour).
Double data-entry is minimized because much of required information is pulled from the patient's chart and presented to the clinician for final editing. Where clinician decisions are required before making selections, the relevant chart data is available via click-to-review pop-up displays that spare the user from having to search the chart.
SmartLinks and SmartLists
Digital ABC forms auto-populate as much of the authorization information requirements as possible. If requested information is not found in the chart, the usual "wildcard" token ("***") is inserted, signaling to the clinician that the needed information must be provided directly, or that the provided information requires clinical interpretation before an ABC form question can be answered. SmartLists invite the submitting clinician to select from among set options when answering questions about qualifying clinical criteria.
Embedded Instructions
Users should look to instructions and options provided within the form selector and forms (click on "?" for help, or on the drug indication wording). These can be selected for more specific instructions, including drug approval particulars. Any options showing in light yellow SmartText blocks will be automatically removed when the form is sent to ABC.
Drug-specific Modules
The ABC special authorization forms in Connect Care continue to grow. A starter set of 40 commonly requested approvals (e.g., Dual/Tripple Puffers, Hypoglycemics, ARNI, SGLT2i, GLP-1 medications) is initially available, and other medications will be added over time.
Sending Blue Cross Forms
It is important to pay attention to the form (letter) recipient. All Blue Cross Special Authorization forms are sent to "Alberta Blue Cross, Clinical Drug Services", which can be found by searching for "Blue Cross" using the "to" section of the Communications activity.
Finding Completed Blue Cross Forms
Completed forms are found in the "Letters" tab of Chart Review, which can be filtered to show "Approval Requests". Recently completed forms can also be reviewed within the "Forms" sidebar, available from the sidebar index that shows for all charts opened to inpatient, emergency or outpatient encounters.