Northwood, Inc. manages prior authorizations and the supplier network for DME/P&O for the following members:

Note: For diabetes supplies, Northwood manages prior authorizations for blood glucose monitors and testing supplies, and insulin pumps and supplies.

• Blue Care Network commercial
  
  Exception: BCN commercial members who have pharmacy benefits through BCN can obtain certain DME products, including continuous glucose monitor, or CGM, products from participating network pharmacies. Prior authorization could be required.
• BCN Advantage^SM
  
  Exceptions:
• BCN Advantage members must obtain CGM products through a participating network pharmacy. Prior authorization could be required.
• UAW Retiree Medical Benefits Trust members with BCN Advantage plans must obtain CGM products through a DME supplier.

For information about DME/P&O for Blue Cross Blue Shield of Michigan commercial and Medicare Plus Blue^SM members, see the Blue Cross Durable Medical Equipment, Prosthetics and Orthotics page.

How to submit prior authorization requests

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

Submit requests before providing services.

Resources

• Procedure codes for which providers must request prior authorization (PDF) — See this document to determine which procedure codes require prior authorization
• Durable medical equipment, prosthetics, orthotics and medical supplies management program: Frequently asked questions for providers (PDF)
• Continuous glucose monitor products: FAQs for prescribing providers (PDF)
• Durable medical equipment and prosthetics and orthotics: For prior authorization determinations (PDF) - Includes information about our utilization management programs

Northwood Inc. is an independent company that manages both prior authorizations and a supplier network for durable medical equipment, prosthetics and orthotics, and medical supplies (including diabetes supplies) for various Blue Cross Blue Shield of Michigan and Blue Care Network members.