Blue Cross Blue Shield of Michigan Utilization Management manages prior authorizations for post-acute care stays (skilled nursing facilities, inpatient rehabilitation centers and long-term acute care hospitals) for:

• Blue Cross commercial members
• Medicare Plus Blue^SM members

For information about post-acute care services for Blue Care Network commercial and BCN Advantage^SM members, see the BCN Post-Acute Care page.

How to submit prior authorization requests

To learn how to submit requests, see our Getting Started page.

Submit requests before providing services.

Resources for services managed by Blue Cross Utilization Management

• Post-acute care requirements: Information for providers (PDF)
• Local rules — See the Services that need prior authorization page on bcbsm.com
• Assessment forms
• LTACH assessment form (PDF)
• SNF/acute IPR assessment form (PDF)
• How to request a peer-to-peer review with a Blue Cross or BCN medical director (PDF)
• Physician peer-to-peer request form (for non-behavioral health cases) (PDF)
• For Medicare Advantage members only: Post-acute care: NOMNC and DENC forms (PDF)

Additional resources

• Holiday closures: How to submit authorization requests for inpatient admissions (PDF)
• Post-acute care: For skilled nursing, rehabilitation and long-term acute care facilities (PDF) — Includes information about our care management and utilization management programs

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