Access & Training
Blue Cross
Referrals & Authorizations
- Prior Authorization
- Acute Inpatient Admissions
- Air Ambulance
- Autism
- Behavioral Health
- Cardiology
- Diabetes Supplies
- DME / P&O
- Medical Benefit Drugs
- Musculoskeletal Services
- Oncology
- Pain Management Services
- Pharmacy Benefit Drugs
- Post-Acute Care
- Private Duty Nursing
- Radiology
- Sleep Studies
- Transplant Services
Blue Cross Products with
Unique Requirements
Additional Resources
Pain Management Services
TurningPoint Healthcare Solutions LLC manages prior authorizations for pain management services for:
- Blue Cross Blue Shield of Michigan commercial fully insured groups, select self-funded groups and members with individual coverage*
Notes:
- This excludes MESSA members.
- This includes UAW Retiree Medical Benefits Trust non-Medicare members, for dates of service on or after May 31, 2021
- Medicare Plus BlueSM members — For dates of service on or before May 1, 2025. For dates of service on or after May 1, 2025, prior authorization isn’t required.
Notes:
- For information about pain management services for BCN commercial and BCN AdvantageSM members, see the BCN Pain Management Services page.
- TurningPoint also manages prior authorizations for orthopedic and spinal procedures; see the Blue Cross Musculoskeletal Services page for details.
Resources
- Procedure codes for which providers must request prior authorization (PDF)
- 2024 updates to TurningPoint medical policies for musculoskeletal and pain management procedures (PDF)
- Musculoskeletal procedure authorizations: Frequently asked questions for providers (PDF)
- Musculoskeletal procedure authorizations: Quick reference for providers (PDF)
- Determining whether procedure codes require prior authorization for a member (PDF)
- TurningPoint Peer to Peer Quick Reference Guide (PDF)
- TurningPoint Advance Practice Practitioner (APP) Peer-to-Peer Process (PDF)
- TurningPoint Provider Training Manual (PDF)
- Pain management: For non-hospice palliative care and for musculoskeletal-related pain management procedures (PDF) — Includes information about care management and utilization management programs
TurningPoint fax forms for prior authorization and postservice change requests
- Pain management: Epidural steroid injections authorization request form (PDF)
- Pain management: Facet joint injections authorization request form (PDF)
- Pain management: Neuroablation procedures authorization request form (PDF)
- Pain management: Sacroiliac joint injections authorization request form (PDF)
- Postservice change request form (PDF)
Training for the TurningPoint program
We offer provider training. To learn more, see our Training Tools page.
*To determine whether you need to submit prior authorization requests for Blue Cross commercial members, see the document titled Determining whether procedure codes require prior authorization for a member (PDF).
TurningPoint Healthcare Solutions LLC is an independent company that manages prior authorizations for musculoskeletal surgical and related procedures for Blue Cross Blue Shield of Michigan and Blue Care Network.