Ereferrals.bcbsm.

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 ...Page i BCN Provider Manual (BCN commercial and BCN Advantage) Revised August 2023 . BCN Provider Manual – 2023 BCN commercial and BCN AdvantageSM. BCN Advantage . This chapter is subject to change. To ensure that you review the most current version, we ... bcbsm.com, ereferrals.bcbsm.com, MiBlueCrossComplete.com, …For BCN commercial members, fax to 1-877-325-5979. For Medicare Plus Blue members, fax to 1-866-392-6465. Call the Blue Cross and BCN Pharmacy Clinical Help Desk at 1-800-437-3803. For BCN commercial members only, mail the request to: Blue Cross Blue Shield of Michigan, Pharmacy Services Mail Code 512B 600 E. Lafayette Blvd. Detroit, …webpage at ereferrals.bcbsm.com Note: If any of the information presented here conflicts with the provider contract, the contract language should be followed. *Clicking this link means that you're leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website.

Online provider search — bcbsm.com has an online provider search that allows you to look for affiliated providers by first selecting the member's Blue Cross or BCN product and then viewing the network choices by type of care and location. More detailed searches are possible by clicking on More Search Options. Once you have located the ...

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. W010723 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

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 andmedical benefit for BCN HMO and BCN Advantage members. Complete this form and fax it to BCN at 1-800-675-7278 along with supporting clinical documentation. Please contact BCN Care Management at 1-800-392-2512 with any questions. **Required for ALL requests** Drug information. ALL REQUESTED INFORMATION MUST BE PROVIDED FOR CONSIDERATION FOR ...Blue Cross/BCN Provider Communications Created Date: 20221111145255Z ...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.Carelon Medical Benefits Management is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage prior authorizations for select services. For more information, go to our . ereferrals.bcbsm.com website.

healthcare 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 services

For drugs covered under the commercial Blue Cross or BCN medical benefit, please see the Blue Cross and BCN Utilization Management Medical Drug List. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. New coverage criteria for certain drugs

referral is required for BCN commercial members whose primary care provider is part of a medical care group based in the East or Southeast region. Note: For dates of service before Jan. 1, 2022, post-service authorization is required for all members. For additional information, refer to BCN's Bariatric Surgery webpage at ereferrals.bcbsm.com. Online provider search — bcbsm.com has an online provider search that allows you to look for affiliated providers by first selecting the member's Blue Cross or BCN product and then viewing the network choices by type of care and location. More detailed searches are possible by clicking on More Search Options. Once you have located the ...©1996-2023 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.BCN commercial and BCN Advantage members. Blue Cross and BCN utilization management medical drug list for : Blue Cross commercial and BCN commercial Drugs marked "Oncology Management Program" are managed by Carelon (formerly AIM). If you think a code may require authorization but it isn't listed, call Carelon at 1-844-377-1278 to inquire.–Articles in BCN Provider News –Web-DENIS messages –One excellent place to go for information is ereferrals.bcbsm.com. Click Radiology Management. Note: ...

Availity is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal services. naviHealth is an independent company that manages authorizations for post-acute care services for Blue Cross Blue Shield of Michigan and Blue Care Network members who have Medicare Advantage plans.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 ...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. W01072322 Jun 2021 ... ... ereferrals.bcbsm.com/docs/common/common-bh-documentation-rqumts-aba.pdf. Carr, J. E., Wilder, D. A., Majdalany, L., Mathisen, D., & Strain, L ...BCN Provider Manual. Look in the section titled "Authorization for behavioral health services." • For Blue Cross commercial and Medicare Plus Blue members, refer to the Behavioral Health webpagen the Blue Cross section of the ereferrals.bcbsm.com website. In additioni , refer to: o Medicare Plus Blue PPO Provider Manual o

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 ... 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

POSTSERVICE CHANGE REQUEST FORM Utilization management toll-free phone: 1-833-217-9670 Utilization management local phone: 313-908-6040 Utilization management fax: 313-879-5509Advantages of using the e-referral system for prior authorization requests instead of calling or faxing. Using the e-referral system is the most efficient way to submit a prior authorization request for services managed by the Blue Cross Blue Shield of Michigan and Blue Care Network Utilization Management departments.BCN Advantage members • Blue Cross and BCN utilization management medical drug list for Blue Cross commercial and BCN commercial members We'll update these lists prior to the effective dates of the change. You can access these lists and other information about requesting prior authorization at : ereferrals.bcbsm.com, at these locations:Blue Cross Blue Shield of MichiganImportant: For Blue Cross Blue Shield of Michigan commercial and Blue Care Network commercial members, Michigan’s prior authorization law* requires health care providers to submit prior authorization requests electronically. If you’re experiencing temporary technical problems, such as a power system or internet outage, you can submit ... Quick Guides. e-referral Quick Guide ( PDF) - A brief overview of what you need to know to start using the e-referral tool. Care management and utilization management programs: Overview for providers ( PDF) - Overview of care management programs for members and utilization management programs for providers. BCN Provider Inquiry Contact ...BCN Healthy Blue Choices POS. Healthy Blue Choices POS. Healthy Blue Choices SM POS is a point-of-service product for FCA non-bargaining employees and retirees that is administered by Blue Care Network. Healthy Blue Choices POS allows the flexibility to receive covered health care services in or out of network without a referral.For BCN members: For DME and P&O, contact Northwood, Inc., at 1-800-393-6432. For diabetes supplies, contact J&B Medical Supply at 1-888-896-6233. For Blue Cross commercial members: For information about DME and diabetes supplies, contact Provider Inquiry at 1-800-249-5103 to determine benefits.management services for Blue Cross Blue Shield of Michigan and Blue Care Network. Quartet is an independent company contracted by Blue Cross Blue Shield of Michigan to connect Blue Cross and BCN members seeking outpatient behavioral health services with the appropriate behavioral health providers.ereferrals.bcbsm.com or on our Provider Resources site under Member Care > Behavioral ... Quartet is an independent company contracted by Blue Cross Blue Shield of Michigan and Blue Care Network to help increase the speed with which fully insured adult members (18 and older) can access behavioral health services. ...

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 risks

Access this document via ereferrals.bcbsm.com to ensure you’re viewing the most up-to-date information. Elective procedures and services ... management services for Blue Cross Blue Shield of Michigan and Blue Care Network members who have commercial plans. *For self-funded plans, the employer assumes the risk for claims costs and ...

To 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 Vanouse-referral welcome page at ereferrals.bcbsm.com. • For members whose primary care physician is in the Mid or West service area and the specialist is outside the Mid or West service area, a global referral must be submitted to the plan. • When the member's primary care physician and specialist are both in the Mid or West service area,Physicians and professionals: 1-800-344-8525. Hospitals or facilities: 1-800-249-5103. Vision and hearing providers: 1-800-482-4047. Federal Employee Program providers and facilities: 1-800-840-4505. While our automated response system is available to any provider who needs it, we strongly encourage providers to log in or learn how to get an ...... ereferrals.bcbsm.com/questionnaire_lumbar_discectomy_hemilaminectomy_w%20wo_discectomy_foraminotomy.pdf https://www.aetna.com/cpb/medical/data/700_799/0743 ...ereferrals.bcbsm.com website. Scroll down the left navigation pane and look for the blue tile at the bottom. We're providing this information so you can plan ahead. We apologize for any inconvenience you may experience while the e-referral system is down. .medical benefit for BCN HMO and BCN Advantage members. Complete this form and fax it to BCN at 1-800-675-7278 along with supporting clinical documentation. Please contact BCN Care Management at 1-800-392-2512 with any questions. **Required for ALL requests** Drug information. ALL REQUESTED INFORMATION MUST BE PROVIDED FOR CONSIDERATION FOR ...BCN commercial and BCN AdvantageSM requests. January 2021 . 1. Check the category that applies to your request: For non-behavioral health facility inpatient admissions: Check one (below), then complete the form and fax it to 1-866-373-9468 or email it to . [email protected]. Note: Effective Jan. 4, 2021, peer-to-peer review requests will notBlue Cross Blue Shield of Michigan Request for Preauthorization Form . Most preauthorization requests can be resolved by contacting Provider Relations and Servicing, or PRS, and requesting member benefits. However, if you would like to submit a request for preauthorization after contacting PRS, you may submit a written request by completing ...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.For Medicare Plus Blue members, fax to 1-866-601-4428. 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: BCBSM Clinical Help Desk. P.O. Box 312320.

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.June 2018. e-referral system is pending outpatient authorization requests for patients with the Blue Cross Blue Shield of Michigan plans. Updated authorization criteria and e-referral questionnaires are in effect. Effective Oct. 1, Prolia ® and Xgeva ® are subject to a site-of-care requirement for BCN HMO SM members.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 …To ensure continued access for current e-referral users. You must login at least once every 90 days to keep you user ID active. If your user ID is not working, please contact Availity ® Client Services at 1-800-AVAILITY (1-800-282-4548).. To sign up as a new e-referral userInstagram:https://instagram. food lion weekly ad williamsburg vasportsmans guide visawww.cfahome.comcopy and paste roast BCN Provider Inquiry Contact Information (PDF) - Provider Inquiry phone and fax numbers for all BCN products. Provider resource guide at a glance (PDF) Summary of key contact information. This summary document helps providers keep phone and fax numbers at their fingertips and is updated as needed, so that the most current information is always ... delivered at ddu uspsmadrag southaven Starting June 1, BCN and Blue Cross are accepting applied behavior analysis claims with 2019 procedure codes. Reminder: Submit BCN initial and follow-up authorization requests for PT, OT and ST to eviCore starting May 27, 2019. Updated authorization criteria and e-referral questionnaire for ethmoidectomy.• 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 gmt to est time zone Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network ...Blue Cross Blue Shield of Michigan 600 E. Lafayette Blvd., Detroit, MI 48226-2998 A nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association Use of this card is subject to terms of applicable contracts, conditions and user agreements. Dental, Vision and Pharmacy providers: file claims according to your network