This page provides Blue Cross Blue Shield of Michigan's authorization requirements, including information that applies to:

• Blue Cross commercial only
• Medicare Plus Blue^SM

For Blue Cross commercial members

Information on requesting authorization – Blue Cross commercial

Utilization management criteria – Blue Cross commercial

Forms – Blue Cross commercial

Air ambulance authorization requests – Blue Cross commercial

Blue Cross PPO (commercial) Provider Manual

For Medicare Plus Blue members

Services that require authorization – Medicare Plus Blue

• Summary of utilization management programs for Michigan providers (PDF)
• Services That Require Authorization – Medicare Plus Blue PPO (PDF)
• About Blue Dot changes to the list of Services That Require Authorization (PDF)
• Submitting acute inpatient authorization requests: Frequently asked questions for providers (PDF)
• Summary of utilization management programs for Inpatient Acute Hospital Medical Admissions (PDF)
• Holiday closures: How to submit authorization requests for inpatient admissions (PDF)
• Diabetes: For coaching, management, behavioral counseling and supplies (PDF) - Includes information about care management and utilization management programs
• Durable medical equipment and prosthetics and orthotics: For authorization determinations (PDF)
• Elective procedures and services: For authorization determinations (PDF) - Includes information about our care management and utilization management programs
• Inpatient medical admissions, acute care (hospitals): For authorization determinations (PDF) - Includes information about our utilization management program
• Post-acute care:
  • Post-acute care services: Frequently asked questions by providers (PDF)
  • Post-acute care: For skilled nursing, rehabilitation and long-term acute care facilities (PDF) - Includes information about our utilization management programs
• Surgeries: For decision support and authorization determinations (PDF) - Includes information about our care management and utilization management programs
• For more utilization management requirements for various services refer to the Provider Toolkit page at bcbsm.com. Look under the "Care management" heading. Under the "Care management" heading, click Preauthorization and utilization management.