Use form to request criteria for BCN authorization decisions (non-behavioral health)

To obtain the review criteria used to make a determination on a specific authorization request for a BCN HMOSM (commercial) or BCN AdvantageSM member, complete the BCN Criteria Request Form (for non-behavioral health cases) and fax it to 1-866-373-9468.

This applies to non-behavioral health authorization requests only.

You can access the BCN Criteria Request Form on this website:

  1. Click BCN.
  2. Click Authorization Requirements & Criteria.
  3. Look under the "Referral and authorization information" heading.

Previously, you called BCN's Utilization Management department to request the criteria. Now you use the form to submit the request. The BCN Provider Manual has been updated to reflect the change.

Posted: March 2019
Line of business: Blue Care Network