How to submit non-behavioral health inpatient authorization requests to Blue Cross and BCN during the May 25 holiday closure
Blue Cross Blue Shield of Michigan and Blue Care Network corporate offices will be closed on Monday, May 25, for Memorial Day.
See below for instructions on submitting non-behavioral health inpatient authorization requests during this closure. Note that all times are Eastern time.
IMPORTANT! For urgent requests, always call the after-hours number 1-800-851-3904 when other options are not available.
| Type of request | What to do |
|---|---|
| Acute inpatient admissions and continued stays |
Submit requests 24/7 through the e-referral system. If the e-referral system is not available:
Note: You can also submit requests through the X12N 278 Health Care Services Review - Request for Review and Response electronic standard transaction. |
| Sick and ill newborns |
|
| Post-acute care admissions |
|
| Other requests | Blue Cross' PPO: Fax the following requests to 1-800-482-1713:
|
Reminder: We've suspended clinical review requirements through May 31, 2020, for acute care medical admissions and for transfers to skilled nursing facilities, due to the COVID-19 crisis. This means that all authorization requests for acute inpatient medical admissions and for the first three days of skilled nursing care following transfer from acute care will be approved without clinical review. However:
- For all members being admitted to an acute care hospital, you still need to submit an authorization request, which will serve as plan notification.
- For members being transferred from an acute care hospital to a SNF:
- For Blue Cross' PPO and BCN HMO members, you still need to submit an authorization request to the plan, which will serve as plan notification.
- For Medicare Plus Blue and BCN Advantage members, you still need to notify naviHealth prior to transferring the member.
Requests submitted to the plan that are received via phone or fax on the May 25 holiday will be entered into the e-referral system by our Utilization Management staff on Tuesday, May 26. Your approval will be available in the system by Tuesday night.
For more information refer to the COVID-19 utilization management changes document.