e-referral system is pending outpatient authorization requests for patients with the Blue Cross Blue Shield of Michigan plans
Recently, an error in the e-referral system has been causing Blue Cross outpatient authorization requests that should not have been entered into the system to pend. Upon submission, providers submitting these authorizations in error receive a case ID and a pending message.
As a reminder, please check requirements before submitting outpatient cases to e-referral:
- For Blue Cross Medicare Plus BlueSM PPO, requirements are outlined in the Services That Require Authorization (PDF).
- Some Blue Cross PPOSM (commercial) member outpatient procedures may require authorization. Visit the eviCore-Managed Procedures page.
- For Blue Cross PPO (commercial) behavioral health requirements, see the For Blue Cross PPO (commercial) members section on ereferrals.bcbsm.com under Blue Cross then the Behavioral Health section.
While this issue is being resolved, we are voiding these cases manually and sending a message to providers why the case has been voided.
Posted: June 2018
Line of business: Blue Cross Blue Shield of Michigan