Guidelines for submitting acute inpatient admission requests to BCN
Authorization requests submitted to Blue Care Network for acute inpatient admissions are accepted only when they are submitted through the e-referral system.
Requests submitted by fax are not accepted, except for the following types of requests, which must be faxed to BCN:
- For facilities reimbursed on the basis of DRGs, concurrent review requests and discharge dates will be accepted via fax. Facilities reimbursed on a per-diem basis must submit concurrent reviews via e-referral.
- Authorization requests for sick or ill newborns must be faxed to BCN. They cannot be submitted through the e-referral system because the newborn is not a member covered by BCN. The BCN nurse reviewer will create a case for the newborn in the e-referral system and you will be able to see it there.
- Requests for enteral and total parenteral nutrition requests must be faxed to BCN.
Faxes are accepted from midnight on Sunday through 4 p.m. on Friday. Faxes are not accepted on weekends. They are also not accepted on holidays when BCN is closed. The holidays observed at BCN are identified in the BCN Provider News issue published prior to the holiday occurring.
The upcoming holidays during which faxes are not accepted are:
- Friday, Dec. 23 through Monday, Dec. 26
- Friday, Dec. 30 through Monday, Jan. 2
- Monday, Jan. 16
The fax numbers to use are:
- For BCN HMOSM (commercial) members: 1-866-313-8433
- For BCN AdvantageSM (commercial) members: 1-866-526-1326
Refer to the document Submitting acute inpatient admission requests to BCN for additional information.
Posted: December 2016
Line of business: Blue Care Network