Archives 2023




June 2023

Submit prior authorization requests for non-emergency air ambulance flights through the Alacura PreAuth Portal (PDF)

July 3-4 holiday closure: How to submit inpatient authorization requests (PDF)

Updated Septoplasty and Blepharoplasty questionnaires in the e-referral system (PDF)

June 19 holiday closure: How to submit inpatient authorization requests (PDF)

How Blue Cross and BCN are handling authorizations for Makena® following FDA announcement (PDF)

Updated Left atrial appendage closure questionnaires in the e-referral system (PDF)

Reminder: Register for a webinar on June 15 or 21 to learn how to submit requests for ABA services through e-referral (PDF)

Elfabrio® and Vyjuvek™ to require prior authorization for Medicare Advantage members starting Aug. 14 (PDF)

e-referral user guides updated (PDF)

Carelon to expand existing prior authorization program starting Sept. 1 (PDF)

We’ll use 2023 InterQual® criteria starting Aug. 1 (PDF)

May 2023

Vyjuvek™ to require prior authorization for most commercial members (PDF)

ElahereTM, Imjudo®, TecvayliTM, LunsumioTM to require prior authorization for most members starting Aug. 23 (PDF)

Clarification: Xgeva® continues to require prior authorization through NovoLogix® for most commercial members (PDF)

Elfabrio® and Omisirge® to require prior authorization for most commercial members (PDF)

e-referral system unavailable on three May-June weekends (PDF)

QalsodyTM to require prior authorization for Medicare Advantage members starting Aug. 1 (PDF)

Updated questionnaires in the e-referral system, starting May 14 (PDF)

Updated medical record documentation guidelines for musculoskeletal procedures (PDF)

Register now for training on how to submit LTACH prior authorization requests through the e-referral system (PDF)

Learn how to submit requests for ABA services through e-referral (PDF)

Updates to list of musculoskeletal procedure codes that require prior authorization (PDF)

QalsodyTM to require prior authorization for most commercial members (PDF)

Some pre-COVID-19 utilization management requirements to resume July 1 (PDF)

e-referral system out of service on two weekends in May (PDF)

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 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 HealthTM provider portal to capture clinical outcomes for CAR-T cell therapy drugs (PDF)

Changes to maternity support program and new menopause support program (PDF)

Updated questionnaire in the e-referral system (PDF)

TzieldTM to require prior authorization for URMBT members with Blue Cross non-Medicare plans (PDF)

e-referral system out of service for maintenance overnight April 15-16 (PDF)

March 2023

April 7 holiday closure: How to submit inpatient authorization requests (PDF)

RolvedonTM will have requirements for URMBT members with Blue Cross non-Medicare plans (PDF)

Prior authorization processes for MESSA members changing June 1 (PDF)

AIM to change its name to Carelon (PDF)

Questionnaire changes in the e-referral system (PDF)

Lamzede® to require prior authorization for Medicare Advantage members starting May 1 (PDF)

Jemperli and OpdualagTM to have site-of-care requirements for BCN commercial members starting July 1 (PDF)

Starting June 1, requests for commercial LTACH admissions and extensions must be submitted through e-referral and not by fax (PDF)

BriumviTM to have a site-of-care requirement for most commercial members starting July 1 (PDF)

e-referral system out of service for maintenance overnight March 18-19 (PDF)

Resources for members coping with the MSU tragedy (PDF)

Changes to Carelon’s (formerly AIM’s) provider portal for medical oncology program (PDF)

Transfer Medicare Advantage members to post-acute care facilities immediately after appeals are approved (PDF)

Updated: Prior authorization changes coming in June (PDF)

Starting June 1, submit prior authorization requests for human organ transplants through e-referral and not by fax (PDF)

Members may call about colorectal cancer screening (PDF)

February 2023

Determining prior authorization requirements for patients with non-Michigan Blue plans (PDF)

Lamzede, Syfovre™ and Vegzelma® to require prior authorization for most commercial members (PDF)

Syfovre™ to require prior authorization for Medicare Advantage members starting April 3 (PDF)

Behavioral health resources needed for members (PDF)

e-referral system out of service for maintenance overnight Feb. 18-19 (PDF)

Adstiladrin® to require prior authorization for Medicare Advantage members starting May 1 (PDF)

CimerliTM and XenpozymeTM to require prior authorization for URMBT members with Blue Cross non-Medicare plans (PDF)

Questionnaires available again in the e-referral system (PDF)

AIM ProviderPortal operating slowly (PDF)

January 2023

Transfer Medicare Advantage members to post-acute care facilities immediately after appeals are approved (PDF)

RebyotaTM to require prior authorization for Medicare Advantage members starting March 1 (PDF)

Adstiladrin® and Stimufend® to require prior authorization for most commercial members starting Feb. 2 (PDF)

e-referral system out of service for maintenance overnight Jan. 21-22 (PDF)

BriumviTM and LeqembiTM to require prior authorization for most commercial members starting Jan. 26 (PDF)

Byooviz® is no longer the preferred ranibizumab drug for Medicare Advantage members (PDF)

Leqembi™ to require prior authorization for Medicare Advantage members starting Jan. 13 (PDF)

Reminder: Assessments and clinical documentation to submit for services received by Medicare Advantage members in SNFs (PDF)

Jan. 16 holiday closure: How to submit inpatient authorization requests (PDF)

Additional drugs to require prior authorization for Medicare Advantage members, starting March 1 (PDF)