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Our provider manuals offer utilization management information that can be helpful to you and are updated regularly. BCN Provider Manual. In the BCN Provider Manual, you'll find information about prior authorization and referral requirements that apply to BCN commercial and BCN Advantage members in these chapters: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.ereferrals.bcbsm.com . Pharmacy benefit . drugs ; Online: Submit through an . electronic prior authorization, or ePA, tool. Alternate methods • Fax: 1-866-601-4425 • Call: 1-800-437-3803 ... Blue Cross Blue Shield of Michigan and Blue Care Network members who have commercial plans.ereferrals.bcbsm.com. The User Guide and Quick Guide are dated September 2022. What’s new • We’ve updated the language when extending service on …ereferrals.bcbsm.com. In the section titled "For both Blue Cross commercial and Medicare Plus Blue members," look under the "General resources" heading. • BCN Behavioral Health at . ereferrals.bcbsm.com. Look under the "Other resources" heading. • On the Provider Resources site, which is accessed through our provider portalBlue Care Network announces date for program changes for breast biopsy (excisional) BCN previously communicated in the Nov.-Dec BCN Provider News, clinical review will be required for breast biopsy (excisional) and CCTA for BCN commercial and BCN Advantage HMO-POS SM and BCN Advantage HMO SM members effective Jan. 1, 2014. The effective date of these changes will be Jan. 6, 2014.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, MI 48226-2998A 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 ...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 healthAdditional referral information appears in the BCN Advantage and Behavioral Health chapters of the manual. The BCN Provider Manual is updated regularly. Updates are designated within the chapters as "Blue Dot" changes. You can identify Blue Dot changes by a blue-dot icon accompanied by a brief explanation of the change in a bold blue text box.e-Referral - News Item. For dates of service on or after Oct. 1, 2018, Trogarzo and Zilretta will be added to the medical drug prior authorization program for Blue Cross PPO (commercial) and BCN HMO SM (commercial) members. Trogarzo will also be subject to a site-of-care requirement for BCN HMO (commercial) members only, effective Oct. 1, 2018.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.Blue Care Network commercial and BCN AdvantageSM April 2023 2 . What is Quartet? 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. Quartet can connectBlue Cross/BCN Provider Communications Created Date: 20221028193448Z ...1-800-392-2512. The e- referral User Guide has been created as a tool to instruct new users in the. system's basic functions and provide some additional suggestions to save time. and avoid errors. Please take a moment to look at the Table of Contents and skim. through the sections to get acquainted with the contents.Attention! Your ePaper is waiting for publication! By publishing your document, the content will be optimally indexed by Google via AI and sorted into the right category for over 500 million ePaper readers on YUMPU.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 …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.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®.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 …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.Important: 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 ...To learn how to submit prior authorization requests for Blue Cross Blue Shield of Michigan and Blue Care Network members, visit the . ereferrals.bcbsm.com. website, click . Blue Cross or BCN, and then click Medical Benefit Drugs. Scroll down to find instructions for submitting prior authorization requests either through the NovoLogix ®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.

• 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 ®You can access all of your cases by searching for them with the reference number or the member's contract number. Blue Cross and BCN will continue to make enhancements to the e-referral system to make it easier to use. Watch for future web-DENIS messages and news items on the ereferrals.bcbsm.com website announcing upcoming updates.For BCN commercial and BCN Advantage members, you can find additional information about PT/OT/ST by therapists (for BCN commercial and BCN Advantage) and physical medicine services by chiropractors and athletic trainers (for BCN commercial) in the following resources: • BCN's Outpatient PT, OT, ST page of the ereferrals.bcbsm.com website.©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.Attention! Your ePaper is waiting for publication! By publishing your document, the content will be optimally indexed by Google via AI and sorted into the right category for over 500 million ePaper readers on YUMPU.

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.E-Referrals is a web-based tool that automates the distribution and management of the referral processes. Access to E-Referrals is given when a business/person is sent a referral request. It is easy to navigate, available 24/7, and provides all the information needed to respond to a referral request at your finger tips.• ereferrals.bcbsm.com: For referral and authorization requirements, select BCN and then Blue Elect Plus POS. • By phone, call Provider Inquiry • To send BCN electronic claims, call 1-800-542-0945. • To send paper claims, mail to: BCN Claims, P.O. Box 68710, Grand Rapids, MI 49516-8710. Blue providers outside Michigan:…

Reader Q&A - also see RECOMMENDED ARTICLES & FAQs. BCN Advantage SM. BCN Commercial Forms. Use the appropriat. Possible cause: BCN Provider Manual. Look in the section titled "Authorization for behavio.