Ereferrals bcbsm.

Starting June 1, submit prior authorization requests for ABA services through e-referral (PDF) Quartet Care Navigation Platform: FAQ for behavioral health providers is available (PDF) Updated questionnaires in the e-referral system, starting April 24 (PDF) Blue Cross and BCN to use Audaire Health TM provider portal to capture clinical outcomes ...Autism services : Billing guideline s and procedu re codes For Blue Cross commercial and Blue Care Network commercial Revised May 2023 . 1 . This document outlines activities, codes and rates for autism services, along with …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 oAccess 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 Blue Cross and BCN members in groups subject to the mandate, benefits went into effect Oct. 15, 2012. - The Oct. 15, 2012, effective date did not apply to all groups. Blue Cross and BCN groups not subject to the mandate have the option to offer the mandated autism benefit. • Find more information about the autism

ereferrals.bcbsm.com BCN e‑referral Template Guide. Save time by creating templates for these referral types. For more information, see the Templates section in the . e-referral User Guide. located at . ereferrals.bcbsm.com. Outpatient Authorizations. Type of . service Authorization : type Service : to/from Number : of service

• 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.

Oct 5, 2023 · ereferrals.bcbsm.com website. Contact Carelon at 1-800-728-8008. Rhinoplasty . Prior authorization is required. Use the e-referral system to submit the prior authorization request and complete the ; rhinoplasty (outpatient) questionnaire. Sacral nerve neuromodulation / stimulation .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)• Facilities interested in applying as a BCN-approved autism evaluation center (AAEC) should submit a letter of intent. Providers whose letters of intent are accepted will be asked to complete a formal application. Additional information is available on BCN’s Autism page at . ereferrals.bcbsm.com > BCN > Autism.New Directions. 1-800-762-2382 8:30 a.m. to 6 p.m. Monday through Friday. Use New Directions' WebPass tool. Federal Employees Program. 1- 800-342-5891. UAW Trust Retiree Medical Benefits Trust

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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 ...

Access this document via ereferrals.bcbsm.com to ensure you're viewing the most up-to-date information. Blue Cross Coordinated Care CoreSM For members with complex, chronic and acute conditions June 2023 : See also: Care management and utilization management programs: Overview for providers 2Elect 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. Updated Medicare local coverage determination for facet joint injections for Medicare Plus Blue SM and BCN Advantage SM members, starting April 25, 2021. For dates of service on or after April 25, 2021, the updated Medicare local coverage determination for facet joint interventions for pain management (L38841) applies.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 ...Click BCN Medical Benefit – Prior Authorization on the Provider Secured Services welcome page. Enter your NPI. This will bring you to the NovoLogix welcome page. BCN's Pharmacy Help Desk. BCN's Pharmacy Help Desk can also input the request on your behalf. You can call the Help Desk at 1-800-437-3803.

Starting May 18, 2023, we're adding a prior authorization requirement for most Blue Cross Blue Shield of Michigan and Blue Care Network group and individual commercial members for the following drug covered under the medical benefit: • Qalsody (tofersen), HCPCS code J3590 ... ereferrals.bcbsm.com website: • Blue Cross Medical Benefit Drugs .Blue Cross and BCN utilization management medical drug list for Blue Cross commercial and BCN commercial members. We'll update this list prior to the effective change of the change. You can access this list and other information about requesting prior authorization on the following pages of the ereferrals.bcbsm.com website:• 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 ®Blue Cross/BCN Provider Communications Created Date: 20221111145255Z ...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 ...BCBSM Clinical Help Desk P.O. Box 312320 Detroit, MI 48231-2320 Need additional assistance? Here's who you can call: For questions about utilization management requirements, call the Blue Cross / BCN Pharmacy Clinical Help Desk at 1-800-437-3803. For questions about the CoverMyMeds web tool, call the CoverMyMeds support center …• Facilities interested in applying as a BCN-approved autism evaluation center (AAEC) should submit a letter of intent. Providers whose letters of intent are accepted will be asked to complete a formal application. Additional information is available on BCN’s Autism page at . ereferrals.bcbsm.com > BCN > Autism.

Member with BCN coverage who is a Blue Cross employee Phone: 1-888-265-4703 Fax: 1-844-318-5145 Calls are serviced only during business hours (Monday through Friday — except holidays — from 8:30 a.m. to 5 p.m.). Member with BCN HMO or BCN Advantage coverage who is not a Blue Cross employee Call the appropriate Provider Inquiry number:

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 inpatient1 day ago · Changes to ereferrals.bcbsm.com Blue Cross commercial, Medicare Plus BlueSM, BCN commercial and BCN AdvantageSM Date posted: October. 12, 2023 1 October 12, 2023: Changes to ereferrals.bcbsm.com We’re changing the ereferrals.bcbsm.com website to make it easier for you to use. Over member, agree to participate in the Case Management Program offered by Blue Cross Blue Shield of Michigan. I understand that this means: 1. My case manager may contact me and/or my care team to discuss my health care needs. My care team includes my authorized representative and healthcare providers (hospital staff, doctors, therapist, etc.). 2.High-tech radiology — This includes procedures for Michigan Blue Cross and Blue Shield Federal Employee Program ® members. In-lab sleep management — Blue Cross Commercial. Proton beam therapy. Echocardiogram services. Medical oncology - This applies to the following: Medicare Plus Blue members.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. Posted: February 2022 Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network When you have an HMO plan, you go to your PCP first to find out. After an exam, she rules out a cold and suspects it may be an allergy. She refers you to an allergist. The referral may be electronic, on paper or called in. Getting a referral doesn't guarantee your plan will cover or help pay for everything. For example, you may have a copay ...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 healthcare®.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.Blue Cross Blue Shield of Michigan

Below 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.

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 Blue Care Network commercial and BCN AdvantageSM Effective April 24, 2022 . 1 . Endoscopy, upper gastrointestinal, for Gastroesophageal Reflux Disease (GERD) We provide coveragefor this procedure for adult members who meet medical necessity criteria. Submit authorization requests through the e-referral system.Blue Cross and BCN acute care inpatient admissions. 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.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)Updated Medicare local coverage determination for facet joint injections for Medicare Plus Blue SM and BCN Advantage SM members, starting April 25, 2021. For dates of service on or after April 25, 2021, the updated Medicare local coverage determination for facet joint interventions for pain management (L38841) applies.A 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 ...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 ...Các Quy trình kỹ thuật Chương XXVIII _ Tạo hình thẩm mỹ được triển khai tại bệnh viện Đa khoa khu vực Cam Ranh. Xem thêm. Quy trình kỹ thuật Chương XXVII _ Phẫu thuật …ereferrals.bcbsm.com. website. *For self-funded plans, the employer assumes the risk for claims costs and pays a fee for administrative services provided by Blue Cross or BCN. **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,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. Accessing e-referral. For BCN commercial members, fax to 1-866-601-4425. For BCN Advantage members, fax to 1-800-459-8027. Call the Blue Cross and BCN Pharmacy Clinical Help Desk at 1-800-437-3803. For BCN commercial members only, …ereferrals.bcbsm.com. website: • Blue Cross Medical Benefit Drugs • BCN Medical Benefit Drugs . Carelon Medical Benefits Management (formerly AIM Specialty Health ) is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage authorizations forBlue Cross and BCN quantity limits for medical drugs. For information on additional drugs that require prior authorization for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans, see the . Medical oncology prior authorization list for UAW Retiree Medical Benefits Trust PPO non-Medicare members.

Through our provider portal: Log in to our provider portal ( availity.com *). Click Payer Spaces on the menu bar and then click the BCBSM and BCN logo. Click the eviCore Provider Portal tile on the Applications tab. By logging in directly to the eviCore provider portal at evicore.com *. You can also call eviCore at 1-855-774-1317.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.April 2023. Updated Experimental and investigational services questionnaire in the e-referral system starting May 1 (PDF) Starting June 1, submit prior authorization requests for ABA …- For Blue Cross and BCN members in groups subject to the mandate, benefits went into effect Oct. 15, 2012. - The Oct. 15, 2012, effective date did not apply to all groups. Blue Cross and BCN groups not subject to the mandate have the option to offer the mandated autism benefit. • Find more information about the autismInstagram:https://instagram. crystal meth package ready or notwater temperature gloucester mathomasville memorial funeral home obituariessteam64 Blue Cross Blue Shield of Michigan and Blue 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 how is roger schaefer doing todayahcccs banner university family care 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 ... coastland center directory Below 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.From 7 a.m. on Saturday, Sept. 21 to 10 p.m. on Sunday, Sept. 22 (Eastern time) 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. You can get to this list anytime from any page of our ereferrals.bcbsm.com website.