How to submit inpatient authorization requests to BCN during upcoming holiday closure
On Monday, Jan. 20, 2020, Blue Cross Blue Shield of Michigan and Blue Care Network corporate offices will be closed for the Martin Luther King, Jr., holiday.
During this office closure, follow the guidelines outlined below when submitting inpatient authorization requests for BCN HMOSM (commercial) and BCN AdvantageSM members.
Acute initial inpatient admissions. Submit these authorization requests as well as concurrent reviews through the e-referral system, which is available 24 hours a day, seven days a week. If the e-referral system is not available, you can fax requests for inpatient admissions and continued stays to BCN HMO (commercial) at 1 866 313 8433 and to BCN Advantage at 1 866 526 1326.
Note: These requests may also be submitted through the X12N 278 Health Care Services Review - Request for Review and Response electronic standard transaction.
Refer to the document Submitting acute inpatient admission requests to BCN for additional information.
Post-acute initial and concurrent admission reviews.
- For BCN HMO (commercial) members, submit these requests by fax at 1-866-534-9994. Refer to the document Post-acute care admissions: Submitting authorization requests to BCN.
- For BCN Advantage members, naviHealth manages these authorizations. Refer to the document Post-acute care services: Frequently asked questions for providers.
Other authorization requests. The types of requests listed below must be submitted by fax. Fax BCN HMO (commercial) requests to 1-866-313-8433. Fax BCN Advantage requests to 1-866-526-1326.
- Authorization requests for sick or ill newborns
- Requests for enteral and total parenteral nutrition
Additional information. You can also call the BCN after-hours utilization management hotline at 1-800-851-3904 and listen to the prompts for help with the following:
- Determining alternatives to inpatient admissions and triage to alternative care settings
- Handling expedited appeals of utilization management decisions
Note: Do not use the after-hours utilization management phone number to request authorization for routine inpatient admissions.
As a reminder, when an admission occurs through the emergency room, we ask that you contact the primary care physician to discuss the member’s medical condition and coordinate care prior to admitting the member.
Posted: January 2020
Line of business: Blue Care Network