Blue Distinction Centers for Bariatric Surgery®
Blue Care Network and Blue Cross Blue Shield of Michigan designate a network of facilities and other providers as Blue Distinction Centers for Bariatric Surgery.
A list of hospitals currently designated as Blue Distinction Centers for Bariatric Surgery is available using the Blue Cross and Blue Shield Association Blue Distinction Center Finder or using the Find a Doctor tool on bcbsm.com.
Note that Blue Distinction Center designations are subject to change. For more information about the Blue Distinction Centers for Bariatric Surgery, please visit the Blue Cross and Blue Shield Association website.
BCN members are encouraged but are not required to have their bariatric surgery performed at a Blue Distinction Center.
BCN Advantage requirement
BCN AdvantageSM members must have their bariatric surgeries performed by BCN-contracted providers (both surgeon and facility). In addition, the facility they select must be part of the BCN Advantage provider network.
Referral, plan notification and authorization requirements
For dates of service on or after Jan. 1, 2022, bariatric surgery for BCN commercial and BCN Advantage members does not require prior authorization. However:
- Standard global referral requirements apply. This means a global referral is required for BCN commercial members whose primary care providers are part of a medical care group based in the East or Southeast region. Referrals arenâ€™t required for other BCN members.
- Plan notification is required for all BCN commercial and BCN Advantage members. Plan notification alerts BCN to a scheduled service and is used for claims processing. No clinical documentation is required. Plan notification must be submitted before services are provided.
For dates of service prior to Jan. 1, 2022, bariatric surgery for BCN commercial and BCN Advantage members requires post-service authorization. Here are the steps to take when requesting authorization:
- Review the Physician Supervised Weight Loss Program Procedure (PDF)
- Submit a post-service authorization request using the e-referral system. Complete either the bariatric surgery questionnaire for BCN commercial members (PDF) or the bariatric surgery questionnaire for BCN Advantage members (PDF).
- Check the status of the authorization request on the e-referral system or by calling BCN Utilization Management at 1-800-392-2512.