This page provides information about home health care for Blue Care Network commercial and BCN AdvantageSM members.
See the Blue Cross Home Health Care page for information specific to Blue Cross commercial and Medicare Plus BlueSM members.
Blue Care Network doesn’t require authorization for home health services. See the “Guidelines for transition” section in the Utilization Management chapter of the BCN Provider Manual.
- For episodes of care that start and end prior to June 1, 2021, BCN Advantage doesn't require authorization for home health care services. See the "Guidelines for transition" section in the Utilization Management chapter of the BCN Provider Manual.
- For episodes of care that start prior to June 1, 2021, and extend through or beyond June 1, 2021: Providers must request authorization through CareCentrix in the following situations:
- Recertification is needed
- Resumption of care is needed
- Significant change in condition occurs
- For episodes of care that start on or after June 1, 2021: Providers must request prior authorization through CareCentrix®.
Home health care agencies can submit prior authorization requests to CareCentrix starting on May 28, 2021.
For more information about the CareCentrix home health care program, see the resources below.
Resources and forms for CareCentrix:
- Home health care: Frequently asked questions for providers (PDF)
- Home health care: Quick reference (PDF)
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