Oncology Services

Resources

Prior authorizations for oncology services are managed as follows.

Service	Members	Managed by
Medical oncology	Visit the following webpages on this website: Blue Cross Medical Benefit Drugs BCN Medical Benefit Drugs
Proton beam therapy	Blue Cross commercial fully insured groups and individual members Medicare Plus Blue^℠ members	EviCore by Evernorth^®
Proton beam therapy	Blue Cross commercial self-funded groups: Includes UAW Retiree Medical Benefits Trust non-Medicare members Excludes Blue Cross and Blue Shield Federal Employee Program^® members	Carelon Medical Benefits Management
Radiation oncology, including proton beam therapy	BCN commercial BCN Advantage^℠	EviCore
Radiation oncology, other than proton beam therapy	Blue Cross commercial fully insured groups and individual members Medicare Plus Blue members	EviCore
Radiation oncology, other than proton beam therapy	Blue Cross commercial self-funded groups — For UAW Retiree Medical Benefits Trust non-Medicare members only	Carelon

For Blue Cross commercial groups, see the Carelon exclusion list for Blue Cross Blue Shield of Michigan Commercial to learn about the health plans, groups, and settings or scenarios for which prior authorization isn't required.
The requirements outlined above don’t apply to the UAW Retiree Health Care Trust (group number 70605) or the UAW International Union (group number 71714).

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.

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.