Archives 2018




December 2018

Effective April 1, FasenraTM and Radicava® are subject to a site-of-care requirement for BCN HMOSM members

BCN changes process for requesting a peer-to-peer review for non-behavioral health cases

Don't issue referrals for BCN AdvantageSM members staying in network

How to submit inpatient authorization requests to Blue Cross during upcoming holiday closures

How to submit inpatient authorization requests to BCN during upcoming holiday closures

Additional updated authorization criteria and e-referral questionnaires

e-referral User Guides, online eLearning updated

Xgeva® to require authorization for BCN AdvantageSM members

November 2018

eviCore to manage two radiopharmaceutical drugs, starting Feb. 1

Complete the provider specialty questionnaire in the e-referral system

Reminder: Submit BCN authorization requests to AIM for cardiology and high-tech radiology procedures

Updated authorization criteria and e-referral questionnaires

How to submit inpatient authorization requests to Blue Cross during upcoming holiday closures

How to submit inpatient authorization requests to BCN during upcoming holiday closures

Medicare Part B medical specialty drug prior authorization lists changing in 2019

October 2018

We're telling BCN AdvantageSM members they don't need referrals

Reminder: Submit BCN authorization requests to AIM for cardiology and high-tech radiology procedures

Additional updated authorization criteria and e-referral questionnaires

Register for Medicare Advantage webinar: Avastin® use for patients with retinal disorders

Onpattro, Poteligeo, Signifor LAR added to medical benefit specialty drug prior authorization program for commercial members

Tell us what you think about our utilization management services — you could win a prize!

Register now for an AIM Specialty Health® ProviderPortalSM webinar

Possible browser certificate error in e-referral for Windows 7 users starting Oct. 16, 2018

Treat Medicare Advantage members with Avastin® before other specialty drugs

Some medical benefit drugs for Medicare Advantage members need step therapy, starting Jan. 1

September 2018

Register today: NovoLogix® refresher course for medical specialty drug prior authorizations

Reminder: Starting Oct. 1, AIM Specialty Health® manages cardiology and high-tech radiology for Blue Care Network

BCN updates sleep study questionnaire in the e-referral system

Additional updated authorization criteria and e-referral questionnaires

Reminder: Effective Oct. 1, Prolia® and Xgeva® are subject to a site-of-care requirement for BCN HMOSM members

Reminder: Starting Oct. 1, additional specialty medications require authorization for BCN AdvantageSM members

August 2018

Fax authorization requests for BCN members moving to a SNF, rehabilitation facility or LTACH

Use in-network laboratories for toxicology, drug-of-abuse testing

Renflexis® requires authorization for BCN AdvantageSM starting Oct. 1

BCN to accept inpatient continued stay reviews and discharge notifications through the e-referral system starting Sept. 4

How to submit Blue Cross inpatient authorization requests during upcoming holiday closures

How to submit BCN inpatient authorization requests during upcoming holiday closures

FAQ available about LLPs and LMFTs

Additional updated authorization criteria and e-referral questionnaires in effect

Phone numbers change for BCN Case Management and Care Transition programs

Reminder: Starting Oct. 1, AIM Specialty Health® to manage cardiology and high-tech radiology services for Blue Care Network

Updated authorization criteria and e-referral questionnaires in effect

Error issue resolved in e-referral system

Reminder: Register for a medical specialty drug prior-authorization web tool refresher course

July 2018

2018 InterQual® criteria implementation delayed until Aug. 6

Starting Aug. 6, updated utilization management criteria used for behavioral health

2018 InterQual® criteria to be implemented starting Aug. 6

Last call for our provider training survey - Respond by July 31

Starting Oct. 1, AIM Specialty Health® to manage cardiology and high-tech radiology services for Blue Care Network

Starting Oct. 1, additional specialty medications require authorization for BCN AdvantageSM members

What to do when you get conflicting results in the e-referral system

Register for a medical specialty drug prior-authorization web tool refresher course

We're updating you on Blue Distinction® Specialty Care

Deleting your browsing history after an e-referral system outage

How to request peer-to-peer review of inpatient admissions

TrogarzoTM and Zilretta® require authorization for commercial members starting Oct. 1

Appealing Blue Cross Medicare Plus BlueSM PPO acute inpatient hospital authorization decisions

How to submit Blue Cross inpatient authorization requests during upcoming holiday closures

How to submit BCN inpatient authorization requests during upcoming holiday closures

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 HMOSM members

Where to get help in using the e-referral system

Effective June 22, submit appeals of eviCore decisions on BCN AdvantageSM requests to BCN, not to eviCore

Reminder: Effective July 1, Krystexxa® and Stelara® (SQ/IV) are subject to a site-of-care requirement for BCN HMOSM (commercial) members

May 2018

Sign up for a webinar on the Blue Cross Medicare Plus BlueSM PPO outpatient facility authorization requirements for specialty medical drugs

Complete the e-referral questionnaires for blepharoplasty and hyperbaric oxygen therapy for BCN members

How to submit Blue Cross inpatient authorization requests during upcoming holiday closures

How to submit BCN inpatient authorization requests during upcoming holiday closures

eviCore to handle BCN initial and follow-up authorization requests for PT, OT and ST starting later in 2018

Starting Aug. 7, FasenraTM and LuxturnaTM require authorization for Medicare Advantage members

No site-of-care requirement for BrineuraTM for BCN HMOSM (commercial) members

April 2018

e-referral not available 6 p.m. Friday, April 27, through 6 a.m. Monday, April 30

Starting June 1, no authorization is required for BCN routine outpatient behavioral health therapy

Medicare Outpatient Observation Notice requirements clarified

Starting June 1, Northwood will manage diabetic shoes and inserts for BCN and Blue Cross Medicare Plus BlueSM PPO members

Last call for our provider manual survey — Respond by April 30 for a chance to win a prize

Effective July 1, no authorization is required for multiple sclerosis medications for Blue Cross, BCN commercial members

BCN members can now get long-acting injectable medications at home

March 2018

Blue Cross, BCN will continue to cover hyaluronic acids until further notice

Effective April 2, use the flight information form for non-emergency air ambulance authorization requests

How to submit Blue Cross inpatient authorization requests during upcoming holiday closures

How to submit BCN inpatient authorization requests during upcoming holiday closures

Tell us what you think about our provider manuals – You could win a prize

Effective July 1, Krystexxa® and Stelara® (SQ/IV) are subject to a site-of-care requirement for BCN HMOSM (commercial) members

Provider forums are coming to a town near you

Effective immediately, two CAR T-cell therapies require authorization for Medicare Advantage members

Effective March 19, fax numbers are changing for BCN medical benefit drug authorization requests

MepseviiTM is subject to a site-of-care requirement for BCN HMOSM (commercial) members

February 2018

Proceed with outpatient authorization requests for knee arthroplasty in e-referral

Two additional medical benefit drugs require authorization for BCN effective April 1, 2018

January 2018

Non-emergency air ambulance services require authorization starting April 2, 2018, for commercial members

Response to Blue Cross PPO inpatient authorization requests submitted through e-referral for group 71575 now fixed

Blue Cross and Blue Care Network will no longer cover hyaluronic acids, starting April 1

How to submit Blue Cross inpatient authorization requests during upcoming holiday closures

How to submit BCN inpatient authorization requests during upcoming holiday closures

Use the e-referral system to submit BCN referrals and authorization requests

Submit functional limitation G codes for BCN AdvantageSM therapy services