Cardiology Services

Resources

Prior authorizations for cardiology services are managed as follows.

Service	Members	Managed by
Cardiology	Blue Cross Blue Shield of Michigan commercial fully insured groups and individual members for dates of service on or after Sept. 1, 2023 Medicare Plus Blue^℠ members	Carelon Medical Benefits Management
Select cardiology services	Blue Care Network commercial BCN Advantage^℠	BCN Utilization Management — Submit through the e-referral system
Various cardiology services, including echocardiology	Blue Care Network commercial BCN Advantage	Carelon Medical Benefits Management
Echocardiology	Blue Cross commercial Fully insured group and individual members Self-funded groups — Exceptions: See the Carelon exclusion list for Blue Cross Blue Shield of Michigan Commercial to learn about the health plans, groups, and settings and scenarios for which prior authorization isn't required. Medicare Plus Blue members	Carelon Medical Benefits Management

How to submit prior authorization requests

To learn how to submit requests, see our Getting Started page.

Submit requests before providing services.

Utilization management criteria

To view, visit our Utilization management criteria page.

Carelon Medical Benefits Management is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage prior authorizations for select services.