Did you know?

BCN Advantage SM. BCN Commercial Forms. Use the appropriate Medication Authorization Request Form below to request prior authorization for a medication that's covered under a member's medical benefits and administered in an outpatient location. Providers located outside of Michigan who don’t have access to the NovoLogix ® online tool must ...To find the CareCentrix training, search on “home health care” and then click the Courses tab. To request access to the provider training site: Click here to register .*. Complete the registration. We recommend using the same email you use to communicate with Blue Cross for provider-related needs. This will become your login ID.To see more planned downtimes and to learn how to handle requests while the system is down, review the list of e-referral system planned downtimes and what to do (PDF). You can get to this list anytime from any page of our ereferrals.bcbsm.com website. Scroll down the left navigation pane and look for the blue tile at the bottom.• Call the Blue Cross and BCN Pharmacy Clinical Help Desk at 1-800-437-3803. • For Blue Cross commercial members only, mail the request to: Blue Cross Blue Shield of Michigan, Pharmacy Services Mail Code 512B 600 E. Lafayette Blvd. Detroit, MI 48226-2998Call the Blue Cross and BCN Pharmacy Clinical Help Desk at 1-800-437-3803. For Blue Cross commercial members only, mail the request to: Blue Cross Blue Shield of Michigan, Pharmacy Services Mail Code 512B 600 E. Lafayette Blvd. Detroit, MI 48226-2998; Alternate methods for submitting prior authorization requests to Carelon• See the BCN referral and authorization requirements for Michigan providers document. • See the "Authorization criteria and preview questionnaires" section of the BCN Authorization Requirements & Criteria page on our ereferrals.bcbsm.com website. • See the Utilization Management chapter of the BCN Provider Manual.Not signed up for our new provider portal (Availity Essentials) yet? Learn more* about the benefits of registering.. e-referral assistance. Refer to the appropriate e-referral User Guide or Web-based training, available on e-referral, or contact your provider consultant. * Clicking this link means that you're leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website.For Blue Cross PPO (commercial) behavioral health requirements, see the For Blue Cross PPO (commercial) members section on ereferrals.bcbsm.com under Blue Cross then the Behavioral Health section. While this issue is being resolved, we are voiding these cases manually and sending a message to providers why the case has been voided. Posted: …September 2023. Changes to preferred drug designations under the medical benefit for most commercial members, starting Jan. 1 (PDF) Management of outpatient diabetes supplies for additional members starting Jan. 1 (PDF) Some diabetes drugs to require prior authorization for Blue Cross and BCN members, starting Jan. 1 (PDF) ereferrals.bcbsm.com. website. As a reminder, we use our authorization criteria, our medical policies and your answers to the questionnaires in the e-referral system when making utilization management determinations on your authorization requests. New questionnaire . On March 26, we'll add a . Breast reductionAccess this document via ereferrals.bcbsm.com to ensure you're viewing the most up-to-date information. Pain management : For non-hospice palliative care and ... procedures for Blue Cross Blue Shield of Michigan and Bl ue Care Network. Title: Blue Cross and BCN - Pain management: For non-hospice palliative care and for musculoskeletal-related ...Carelon-Managed Procedures (formerly AIM) Providers must obtain authorization from Carelon Medical Benefits Management (formerly AIM Specialty Health ®) for the following services: Cardiology services - Medicare Plus Blue SM. This includes cardiac implantable devices and services. High-tech radiology - This includes procedures for Michigan ...BCN Care Management provider call volumes high. BCN Care Management is experiencing high call volumes. To avoid waiting on the phone line, providers should use BCN's e-referral system to submit or check the status of referrals or requests for clinical review.We encourage providers to call the Medical Information Specialist line at 1-800-392-2512 with urgent requests only.e-referral system unavailable on three May-June weekends (PDF) Qalsody TM to require prior authorization for Medicare Advantage members starting Aug. 1 (PDF) Updated …Page 1 and 2: User Guide e-referral on the iEXCHA Page 3 and 4: Table of Contents Section I: Gettin Page 5 and 6: Logging in Enter your ID (usually t Page 7: …For BCN commercial and BCN Advantage members, call 1-844-377-1278. For Blue Cross commercial and Medicare Plus Blue members, call 1-800-728-8008. If Carelon is unable to accept requests by phone due to technical problems, submit the request to Blue Cross or BCN using one of the following methods: BCN Behavioral Health uses Change Healthcare's InterQual Behavioral Health Criteria as utilization management guidelines subject to the modifications posted below. To request a copy of the specific InterQual criteria used to make a decision on a member's case, call BCN Behavioral Health at 1-877-293-2788. Modifications of InterQual criteria ...Fax requests to 1-866-411-2573. Follow the current process. Fax requests to eviCore healthcare at 1-844-407-5293. Federal Employee Program members with contract eligibility issues. Call the Blue Cross after-hours urgent hotline at 313-448-3619. Find additional e-referral system resources at ereferrals.bcbsm.com.Blue Cross Blue Shield of MichiganBCN Care Management provider call volumes high. BCN Care Management is experiencing high call volumes. To avoid waiting on the phone line, providers should use BCN's e-referral system to submit or check the status of referrals or requests for clinical review.We encourage providers to call the Medical Information Specialist line at 1-800-392-2512 with urgent requests only.Authorization Requirements & Criteria page at ereferrals.bcbsm.com. Acute and Post-acute care facilities — Non-Michigan (without access to Availity) (Acute Inpatient …Access this document via ereferrals.bcbsm.com to ensure you're viewing the most up-to-date information. Blue Cross Coordinated Care CoreSM ... is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal and electronic data interchange services. Title: Blue Cross and BCN ...

Blue Cross Blue Shield of Michigan and Blue Care Network offer care management programs and support services to members. These programs vary based on member coverage and may be administered by Blue Cross or BCN staff or by contracted vendors. Care management programs provide patient support by identifying patients with health riskshealthcare for Blue Cross and BCN. You can submit retroactive authorization requests to eviCore healthcare ® through July . 29, 2022, for dates of service prior to April 1, 2022. Additional information is available on the . eviCore-Managed Procedures page. in the Blue Cross section at ereferrals.bcbsm.com. Post-acute care servicesBelow are links to documents detailing Blue Care Network's authorization and referral requirements for services managed by BCN, including lists of procedures that require authorization and authorization criteria and preview questionnaires for various procedures. These apply to services other than drugs covered under the medical benefit.The standard BCN ID card layout ID cards for BCN products include the following: > Subscriber Name: Name of the subscriber or member. > Subscriber ID: Alphanumeric identifier composed of a three‑character BCN prefix followed by a BCN‑issued contract number. Use this number for billing and checking eligibility and benefits.

ereferrals.bcbsm.com website, on these webpages: • Blue Cross Authorization Requirements & Criteria page • BCN Authorization Requirements & Criteria page Here are some additional Blue Cross and BCN holiday closures that will occur during 2023, so you can plan ahead: • Floating Independence Day, Monday, July 3, 2023Skilled Nursing Facility and Acute Inpatient Rehabilitation form for Blue Cross and BCN commercial members. Michigan providers should attach the completed form to the request in the e-referral system. Non-Michigan providers should fax the completed form using the fax numbers on the form. PDF.Time is running out to give us your opinion on provider training. You have until July 31 to complete our online survey. Your response will help us improve the way we distribute information to you. Thank you for your time and your input. Posted: July 2018. Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network.…

Reader Q&A - also see RECOMMENDED ARTICLES & FAQs. Blue Cross Blue Shield of Michigan and BCN Care Network provide ut. Possible cause: Call the Blue Cross and BCN Pharmacy Clinical Help Desk at 1-800-437-3803. .