Oncology Services Resources
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Shared Resources
Resources for services managed by EviCore
- Services reviewed by eviCore for Blue Cross and BCN
— Outlines the types of services for which eviCore manages prior authorizations, how to submit requests, where to find clinical criteria and guidelines, and more - Authorizations Quick Reference Guide — Explains how to submit prior authorization requests to eviCore
Additional Resources
- Procedure codes for which providers must request prior authorization — See this document to determine which procedure codes require prior authorization
- Oncology: For cancer support, medical oncology and radiation oncology — Includes information about utilization management programs
Blue Cross Resources
Resources for services managed by Carelon
- For URMBT non-Medicare members:Radiation Oncology Prior Authorization List for UAW Retiree Medical Benefits Trust non-Medicare members — A list of radiation oncology procedures that require prior authorization for URMBT non-Medicare members. Includes modalities, grouper ID required codes and grouper names
- Frequently asked questions about Carelon: For cardiology, radiology (high technology) and sleep studies (in lab)— Answers to questions about prior authorization requirements for cardiology services, high-tech radiology services and in-lab sleep studies
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.
EviCore by Evernorth is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage prior authorizations for select services.
Frequently accessed documents
Additional resources
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