Changes start May 1 for authorization requests submitted for inpatient acute medical / surgical admissions

The following changes will go into effect for authorization requests submitted to Blue Care Network for inpatient acute medical / surgical admissions:

• From May 1 through June 30, 2016, providers are strongly encouraged to submit these authorization requests via the e-referral system. Faxes will be accepted during certain times, however. The details about faxing are outlined later in this news item.
• Beginning July 1, 2016, these authorization requests will be accepted only when they are submitted through the e-referral system. Requests submitted by fax will no longer be accepted.

This applies to all BCN lines of business, including for BCN HMO^SM (commercial) members and BCN Advantage^SM (BCN Medicare Advantage) members.

In addition, the fax numbers to use in submitting requests are changing.

Here are the details you need to know.

Fax time frames. From May 1 through June 30, 2016, faxed requests will be accepted starting at midnight each Monday through noon on the following Friday. Faxes will not be accepted during the following times:

• From noon on Friday through midnight on the following Sunday
• Anytime on the day prior to a holiday on which BCN offices are closed. (The holidays observed at BCN are identified in the BCN Provider News issue published prior to the holiday occurring.)

Requests submitted by fax during these time frames will not be processed.

Fax numbers. The fax numbers to use in submitting requests are changing.

Use these new fax numbers from May 1 through June 30 to submit requests and to provide concurrent reviews and discharge dates:

• For BCN HMO (commercial) members: 1-866-313-8433
• For BCN Advantage members: 1-866-526-1326

The current fax numbers will go out of use starting May 1. These fax numbers are 1-866-652-8985 and 1-866-578-5482. On May 1, please delete references to these fax numbers in the materials you use.

Submit via e-referral. Requests to authorize inpatient acute medical / surgical admissions can be submitted via the e-referral system right now but beginning July 1, 2016, they must be submitted via e-referral. Requests submitted by fax on or after July 1 will not be accepted.

To access the e-referral system, do the following:

1. Click Login on this website.
2. Insert your Provider Secured Services user name and password.
3. Click Login.
4. Click BCN e-referral on the page that opens.

Sign up for e-referral. If you haven't yet signed up for access to the e-referral system, click Sign Up or Change a User on this website. Follow the instructions to complete the appropriate Provider Secured Services application forms.

We encourage you to sign up immediately, since you'll need access to the e-referral system on July 1.

Posted: March 2016
Line of business: Blue Care Network