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Select send attachment (s) for more information. Upload the completed form and attach supporting documentation. Within the tool, download, complete and save the predetermination request form. Provider directory (for all medical, dental and vision providers) pharmacy directory. Web electronic predetermination of benefits user guide. Select claims & payments from the navigation menu. Web preferred drug list (pdl) mail service registration and prescription order form. Predetermination approvals and denials are usually based on provisions in our medical policies. Here are a few things to know: An electronic predetermination request user guide is available in the provider tools section of our website. Web a predetermination of benefits is a voluntary, written request for review of treatment or services that may be considered experimental, investigational or cosmetic. Bcbsil will notify the provider when the final outcome has been reached. Complete the required data elements. Web log in to availity. Dcfs youth in care program. Web download and complete the predetermination request form. All applicable fields are required. Availity’s attachments tool allows providers to quickly submit electronic predetermination of benefits requests and attach supporting clinical documentation for blue cross and blue shield of illinois (bcbsil) members. Upload the completed form and attach supporting documentation.