TurningPoint Healthcare Solutions LLC manages prior authorizations for:

• Orthopedic procedures
• Spinal procedures

This requirement applies to:

• Blue Care Network commercial members
• BCN Advantage^SM members

Notes:

• For information about musculoskeletal services for Blue Cross commercial and Medicare Plus Blue^SM members, see the Blue Cross Musculoskeletal Services page.
• TurningPoint also manages prior authorizations for pain management procedures; see the BCN Pain Management Services page for details.

Resources

• Musculoskeletal procedure codes that require authorization by TurningPoint (PDF)
• Musculoskeletal procedure code substitutions for orthopedic and spinal surgeries (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)
• TurningPoint Peer to Peer Quick Reference Guide (PDF)
• TurningPoint Advance Practice Practitioner (APP) Peer-to-Peer Process (PDF)
• TurningPoint Provider Training Manual (PDF)
• Musculoskeletal services: For authorization determinations (PDF) — Includes information about the utilization management program

TurningPoint fax forms for prior authorization and postservice change requests

• Joint and spine procedures 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.

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.