Ereferrals.bcbsm.

Blue Care Network commercial and BCN Advantage. SM. Clinical review is required for adult members (age ≥18). The medical necessity criteria are outlined below. CPT codes: *93653, *93654 and *93656. Atrial fibrillation (AF) by ECG . One of the following must be met: 1. Paroxysmal atrial fibrillation and ALL: a. Must have one of the following ...Access 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 ... for Blue Cross Blue Shield of Michigan and Blue Care Network. Title: Blue Cross and BCN - Pain management: For non-hospice palliative care and for musculoskeletal-related pain ...Use the BCN Provider Resource Guide to locate the BCN help you need. Go to ereferrals.bcbsm.com and click on Quick Guides. Keep these phone numbers handy: • For coverage, claims or primary care physician assignment, call BCN Provider Inquiry: 1-800-344-8525 • For technical support with BCN systems, call the Web Support Help Desk: 1-877-258-3932Services available for these products (may not apply to all groups or individual members): Blue Cross commercial Medicare Plus Blue BCN commercial BCN Advantage . Blue Cross Blue Shield of Michigan and Blue Care Network offer the following programs to members. Programs are provided by Blue Cross, BCN and the vendors listed below.

• BCN clinical program information, including behavioral health, outpatient therapy, radiology and sleep studies • Sample BCN questionnaires to help you prepare authorization requests for select procedures • Quick guides All visitors can access the resources at ereferrals.bcbsm.com, but you must have a login and password to get to the securede-referral Provider Search feature — Within the e-referral tool, you can search by provider name or national provider identifier. When you have a member selected and then go to select a provider, the system will indicate if the provider is "in" or "out" of network for that member. For more information, see: e-referral User Guide ( PDF) Online ...

BCN Advantage SM; Note: Services associated with this procedure code already require prior authorization for most Blue Cross commercial members. Submitting prior authorization requests. Submit prior authorization requests to AIM. For information on how to submit requests and for other resources, visit these webpages on our ereferrals.bcbsm.com ...

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 …Updated: Blue Cross continues to pay claims during our union represented employee work stoppage at Blue Cross (PDF) Assisted reproductive technology benefit expanded, starting Jan. 1. 2023 (PDF) Vyvgart Hytrulo to have a site-of-care requirement for most commercial members starting Jan. 1 (PDF) Reminder: Changes for in-lab sleep studies to ...Go to ereferrals.bcbsm.com. 2. Click on Sign Up or Change a User. Health e-Blue ... Network patient data and Blue Cross Blue Shield of Michigan Medicare Advantage patient data (Health e-Blue application) For technical help with BCN systems, call the Web Support Help Desk at 1-877-258-3932.Musculoskeletal Services. . Musculoskeletal Services. Providers must obtain authorization from TurningPoint Healthcare Solutions LLC for: Orthopedic procedures. Pain management procedures. Spinal procedures. This requirement applies to: Blue Cross commercial fully insured groups, select self-funded groups and members with individual coverage*.

- For BCN Advantage members, call 1-800-242-3504 or fax to 1-866-752-5769. - Transplant procedures must be performed in facilities approved by Medicare for the procedure that will be performed. - If additional assistance is needed for a member, contact our Care Management department at 1-800-845-5982.

Refer to BCN's Musculoskeletal Services page at ereferrals.bcbsm.com. • For dates of service prior to July 1, 2020, submit the request to BCN Utilization Management through …

Blue Cross Blue Shield of Michigan and Blue Care Network offer care management programs and support services to members. We also provide utilization management programs. These programs vary based on member coverage and may be administered by Blue Cross or BCN staff or by contracted vendors.Elect Plus POS, refer to BCN's Blue Elect Plus POS webpage on the ereferrals.bcbsm.com website. Blue Elect Plus POS is available Jan. 1, 2021. Note: As a rule, physicians must follow the authorization requirements that apply to the region in which the headquarters for their medical care group is located.Login | Register | My online account | bcbsm.comNot 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 …is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal services. Confidentiality notice: This transmission contains confidential inform ation belonging to the sender that is legally privileged. This information is intended only for use of the individual or entity named above.medicine services for BCN members delivered by chiropractors. eviCore is an independent company that does not provide Blue Cross or Blue Shield products or services and that is solely responsible for the products or services it provides. 3 and at least one passive range of motion measurement, even if that measurement is within ...

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 48226-2998; Alternate methods for submitting prior authorization requests to Carelonereferrals.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, 2023For BCN commercial, call 1-800-482-5982. For BCN Advantage, call 1-800-431-1059. Additional information. As a reminder, you can access resources related to authorizations and referrals on our ereferrals.bcbsm.com website. Click either Blue Cross or BCN and then use the links in the left navigation to reach information related to specific services.When submitting requests before Sept. 17. Prior to Sept. 17, fax your requests for preservice review as follows. For Blue Cross members: Fax to Provider Inquiry at 1 866 311 9603. For BCN members: Fax to the Medical Drug Help Desk at 1 877 325 5979.Blue Cross Blue Shield of Michigan definitions • Prior authorization — A process that allows physicians and other professional providers to determine, before treating a patient, if Blue Cross Blue Shield of Michigan will cover the cost of a proposed service. Blue Cross requires prior authorization for services or

BCN's Blue Elect Plus POS webpage on the . ereferrals.bcbsm.com website. For more details about Healthy Blue Choices POS, refer to BCN's Healthy Blue Choices POS webpage. Inpatient services Inpatient admissions: BCN Utilization Man agement must be notified of acute non-behavioral health inpatient

Watch for news on system updates, training and other topics at ereferrals.bcbsm.com. *Blue Cross Blue Shield of Michigan doesn’t own or control this website. Availity® 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. W010723A BCN-approved autism analysis evaluation center, or AAEC, participating with the member's health plan, must make or confirm a diagnosis of ASD for the member. Note: If the member has a concern about obtaining an AAEC evaluation, please call BCN Behavioral Health at 1-800-482-5982. The treatment plan prepared by the AAEC must include a ...Starting Oct. 1, AIM Specialty Health ® to manage cardiology and high-tech radiology services for Blue Care Network. For dates of service on or after Oct. 1, 2018, AIM Specialty Health will manage the authorization process for cardiology and high-tech radiology procedures for BCN HMO SM (commercial) and BCN Advantage SM members. We first communicated about this in the article AIM Specialty ...Musculoskeletal Services. Providers must obtain authorization from TurningPoint Healthcare Solutions LLC for: Orthopedic procedures. Pain management procedures. Spinal procedures. This requirement applies to BCN commercial and BCN Advantage SM members. For information about musculoskeletal services for Blue Cross commercial and Medicare Plus ...Access the e-referral tool through our provider portal. Log in at availity.com *. Click Payer Spaces at the top. Click the BCBSM BCN logo. Look for e-referral on the Applications tab of our Payer Space. 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 ...• BCN Utilization Management department • eviCore healthcare® Keep reading to learn which members have access to or requirements under these programs. Programs may not apply to all members. This document is subject to change. Access this document via ereferrals.bcbsm.com to ensure you’re viewing the most up-to-date information.Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network ...BCN's Blue Elect Plus POS webpage on the . ereferrals.bcbsm.com website. For more details about Healthy Blue Choices POS, refer to BCN's Healthy Blue Choices POS webpage. Inpatient services Inpatient admissions: BCN Utilization Man agement must be notified of acute non-behavioral health inpatientTo access the list of Services That Require Authorization, visit ereferrals.bcbsm.com and click Blue Cross. Then click Authorization Requirements & Criteria on the left navigation bar. December 2017 . Blue Dot changes to the Blue Cross Medicare Plus Blue Service / Topic Vanous

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 …

POSTSERVICE CHANGE REQUEST FORM Utilization management toll-free phone: 1-833-217-9670 Utilization management local phone: 313-908-6040 Utilization management fax: 313-879-5509

Go to ereferrals.bcbsm.com. Click Blue Cross. Click Medical Benefit Drugs. Scroll to the Blue Cross commercial column. Review the information in the "How to submit authorization requests electronically using NovoLogix" section. More about the authorization requirements. Authorization isn't a guarantee of payment.• BCN Medical-Benefit Drugs If you need help with the NovoLogix tool, contact the Web Support Help Desk at 1-877-258-3932. *Clicking this link means that you’re leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website. While we recommend this site, we’re not responsible for its content. Availity ®A Blue Cross-approved autism evaluation center, or AAEC, participating with the member’s health plan, must make or confirm a diagnosis of ASD for the member. Note: If the member has a concern about obtaining an AAEC evaluation, please call New Directions at 1-877-563-9347. The treatment plan prepared by the AAEC must include a recommendation ...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.For Blue Cross Blue Shield of Michigan on behalf of Blue Cross and Blue Shield Federal Employee Program® Michigan members July 2023 1 . In this document . ... ereferrals.bcbsm.com website. Procedures that require prior authorization by Carelon Radiology (high technology)— This document is a supplement to the BCN Referral / Clinical Review Program. — 2 BCN Clinical Review Medical Necessity Criteria / Benefit Review Requirements / UPD OCT 2016 Requested service Required clinical criteria and information Note: Refer to the BCN Referral / Clinical Review Program for referral and review requirements. BiofeedbackBCN Advantage SM members. This information is currently being requested for select BCN commercial prior authorization requests. You can find information about AIM's requirements related to services for Blue Cross commercial members on our ereferrals.bcbsm.com website, on the . Blue Cross AIM-Managed Procedures webpage.Access this document via ereferrals.bcbsm.com to ensure you're viewing the most up-to-date information. Post-acute care For skilled nursing, rehabilitation and long-term acute care ... Blue Cross Blue Shield of Michigan and Blue Care Network members who have Medicare Advantage plans. Title: Post-acute care: For skilled nursing, rehabilitation ...Access this document via ereferrals.bcbsm.com to ensure you’re viewing the most up-to-date information. Laboratory For genetic testing and molecular testing ... is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal and• ereferrals.bcbsm.com: For referral and authorization requirements, select BCN and then Healthy Blue Choices POS. Provider Inquiry Physicians/professionals: 1-800-344-8525 Hospitals/facilities: 1-800-249-5103 When you receive health care services • You can see any doctor, without a referral from your primary care provider. But you'll pay ...

requests for BCN members Skilled nursing facilities that submit prior authorization requests for physical, occupational or speech therapy for BCN commercial or BCN Advantage members in a Basic bed should submit the request to BCN Utilization Management through the e-referral system. Don’t submit the request to eviCore …Carelon-Managed Procedures (formerly AIM) Providers must obtain prior authorization from Carelon Medical Benefits Management (formerly known as AIM Specialty Health ®) for: In-lab sleep studies for BCN commercial members — For dates of service on or after Sept. 1, 2023. Select cardiology and radiology services for BCN commercial and BCN ...Blue Cross Blue Shield of Michigan and BCN Care Network provide utilization management programs. These programs vary based on member coverage and may be administered by Blue Cross or BCN staff or by contracted vendors. Utilization management programs focus on ensuring that patients get the right care at the rightInstagram:https://instagram. 2323 west illinois avenueradar weather las vegasusps distribution center san bernardinoestate sales champaign il Shield of Michigan and BCN can contact Availity to get access to Blue Cross and BCN information as if they’re a Michigan provider. Ancillary providers who have taken this step should follow the instructions in the . Michigan . providers: Look up requirements for a member who has coverage through Blue Cross Blue Shield of Michigan or eagle river go kartsst maries gazette obituaries Access the e-referral tool through our provider portal. Log in at availity.com *. Click Payer Spaces at the top. Click the BCBSM BCN logo. Look for e-referral on the Applications tab of our Payer Space. mcbul 1500 Online Self-paced Learning Modules. We have developed interactive learning modules to help you learn core functionalities and features of the e-referral tool. Please click the title link in the table below to start each module. Module. Audience. BCN. Blue Cross. 1.©1996-Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. We provide health insurance in Michigan.