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Private Duty Nursing

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Blue Cross Blue Shield of Michigan and Blue Care Network require prior authorizations for private duty nursing as follows.
Service Members Managed by
Private Duty Nursing* Some BCN commercial groups BCN Utilization Management — Submit through the e-referral system.
Some Blue Cross commercial groups Blue Cross Utilization Management — Submit through the e-referral system.

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.

Not all groups have private duty nursing as a benefit. Check each member’s eligibility and benefits prior to performing services.