Starting Feb. 28, a new questionnaire will open in the e-referral system for procedures by providers who aren't contracted with BCN

Starting Feb. 28, 2021, an Out-of-network providers questionnaire will open in the e referral system when you submit a prior authorization request for a procedure to be performed by a provider who isn’t contracted with BCN.

This questionnaire will open for both BCN commercial and BCN AdvantageSM members.

In addition, if the prior authorization request is for a procedure that already requires you to complete a questionnaire, you'll need to complete two questionnaires:

On the website, we'll add a preview questionnaire that shows the questions you'll need to answer in the Out-of-network provider questionnaire. To view the preview questionnaire, click BCN and then click Authorization Requirements & Criteria. Scroll down and look under the "Authorization criteria and preview questionnaires" heading.

As a reminder, we use our authorization criteria, our medical policies and your answers to the questionnaires in the e-referral system when making utilization management determinations on your authorization requests.

Posted: February 2021
Line of business: Blue Care Network