Updated e-referral system questionnaires will be released for BCN and Medicare Plus Blue^SM PPO on Feb. 2, 2020

In the January-February issue of BCN Provider News (page 41) and in the January issue of The Record, we listed the questionnaires that we expected to release in the e-referral system by Jan. 26, 2020.

Most of the questionnaires listed in the articles were updated on Dec. 8, 2019. However, we had to postpone the release of the following questionnaires to Feb. 2:

• Breast reduction - We'll combine the Breast reduction, adult and the Breast reduction, adolescent questionnaires for BCN HMO^SM and BCN Advantage^SM members into a single questionnaire for both adult and adolescent BCN HMO and BCN Advantage members.
• Spinal cord stimulator or epidural or intrathecal catheter (trial or permanent placement) — We'll replace this questionnaire with the following three questionnaires:
  • Spinal cord stimulator - For BCN HMO members
  • Spinal cord stimulator - For Medicare Plus Blue and BCN Advantage members
  • Intrathecal catheter — For Medicare Plus Blue, BCN HMO and BCN Advantage members

We'll also update the following questionnaire on Feb. 2:

• Sleep studies - Opens only for BCN HMO and BCN Advantage members

Here's some additional information you need to know:

• We'll update the preview questionnaires, authorization criteria and medical policies on this website for the questionnaire updates soon.
• We use our authorization criteria and medical policies and your answers to the questionnaires when making utilization management determinations on your authorization requests.
• For all of these services, you'll soon be able to access preview questionnaires on this website. The preview questionnaires show the questions you'll need to answer in the actual questionnaires that open in the e-referral system. This can help you prepare your answers ahead of time. To find the preview questionnaires:
• For BCN: Click BCN and then click Authorization Requirements & Criteria. Scroll down and look under the "Authorization criteria and preview questionnaires" heading.
• For Medicare Plus Blue: Click Blue Cross and then click Authorization Requirements & Criteria. In the "Medicare Plus Blue PPO members" section, look under the "Authorization criteria and preview questionnaires - Medicare Plus Blue PPO" heading.