Advantages of using the e-referral system for prior authorization requests instead of calling or faxing

Using the e-referral system is the most efficient way to submit a prior authorization request for services managed by the Blue Cross Blue Shield of Michigan and Blue Care Network Utilization Management departments. It’s also the easiest way to check the status of a request you've submitted.

Submitting a request

Here are some advantages to using the e-referral system to submit prior authorization requests:

• Requests that involve a questionnaire and that meet criteria can be automatically approved through e-referral, with no waiting.
• Utilization Management department phones are busy. Using e-referral is the best way to submit a prior authorization request quickly. No waiting on hold.
• The e-referral system is available anytime, day or night. While it's best to submit prior authorization requests before the service is performed, the request can be submitted anytime using e-referral.
• Required clinical documentation can be attached to authorization requests in the e referral. No need to fax it.
• Using e-referral instead of faxing speeds up these tasks:
  • Requesting extensions of approved authorization requests
  • Requesting continued stays
  • Submitting discharge dates

Checking the status of a request

You can use the e-referral system to check the status of a request you've submitted. The status of the request will be one of these:

• Pending decision
• Fully approved
• Partially approved
• Denied
• Voided

You can see the case status in the dashboard, in the Status column. The case status is also visible when the case is opened, at the upper left of the screen.

Additional information

For additional information on using e-referral, refer to the e-referral User Guide (PDF).

For information about registering for access to the e-referral system, refer to the Sign up or Change a User webpage.

Posted: January 2022
Lines of business: Blue Cross Blue Shield of Michigan and Blue Care Network