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BCN BLUE CROSS Full Site BCN Blue Cross Access & Training Getting Started Training Tools Additional Resources Blue Distinction Centers Provider Manuals News Archive bcbsm.com Home Outage alert This website will be unavailable from 10 p.m. on Saturday, Jan. 12 until 6 a.m. on Sunday, Jan. 13 while we make upgrades to our web system. We apologize for the inconvenience.Set up e-referral and Health e-Blue in Availity Determine prior authorization requirements for members E-referral system maintenance times and what to do Submitting requests for inpatient admissions on holidays Utilization management programs for Michigan providers Care management and utilization management programs Blue Cross BCN Show All  Spevigo SC to have requirements for most commercial members starting April 25 (PDF)May 2024 Beqvez will require prior authorization for Medicare Advantage members starting June 1 (PDF) Syfovre, Izervay and Elfabrio to have requirements for URMBT members with Blue Cross non-Medicare plans (PDF) Prior authorization no longer required for autism-related PT, OT and ST for BCN commercial members (PDF) e-referral system unavailable on two weekends in May (PDF) Step therapy requirement added for botulinum toxins for Medicare Advantage members starting Aug. 5 (PDF) Update: Beqvez to require prior authorization for most commercial members starting May 9 (PDF) April 2024 Pemfexy and Pemrydi RTU to have additional step therapy requirements for most members (PDF) Changes to the Facial feminization surgery and chondrolaryngoplasty questionnaire in the e-referral system (PDF) Hercessi to require prior authorization for most commercial members starting May 16 (PDF) Save time: Submit only required information about inpatient acute care medical / surgical admissions (PDF) Additional drugs to have a site-of-care requirement for some commercial members, starting Aug. 1 (PDF) Guidelines for using the Autism diagnostic evaluation results form (PDF) Change to prior authorization process for Blue Cross commercial members in Michigan whose plans have local provider networks (PDF) TurningPoint opens peer-to-peer reviews to advanced practice providers for musculoskeletal and pain management procedures (PDF) Omvoh SC and IV to have a step therapy requirement for most commercial members starting June 3 (PDF) Spevigo SC to have requirements for most commercial members starting April 25 (PDF) e-referral system out of service for maintenance overnight April 20-21 (PDF) Amtagvi will have additional requirements for most commercial members, starting May 28 (PDF) Winrevair SQ to require prior authorization for most commercial members (PDF) Procedure codes that require prior authorization through BCN (PDF) Cosentyx IV to have a site-of-care requirement for most commercial members starting July 1 (PDF) Winrevair to require prior authorization for Medicare Advantage members starting May 1 (PDF) Vyjuvek to have a site-of-care requirement for most commercial members starting April 4 (PDF) March 2024 Questionnaire changes in the e-referral system starting March 31 (PDF) Cinryze, Elfabrio and Evkeeza to have a site-of-care requirement for most commercial members starting July 1 (PDF) Columvi, Daxxify and Qalsody to require prior authorization for URMBT members with Blue Cross non-Medicare plans (PDF) March 29 holiday closure: How to submit authorization requests for inpatient admissions (PDF) Lenmeldy to require prior authorization for most commercial members starting March 28 (PDF) Step therapy requirement to be added for VPRIV and Elelyso for Medicare Advantage members starting June 1 (PDF) Tofidence will require prior authorization for Medicare Advantage members starting May 1 (PDF) Elrexfio and Talvey to require prior authorization for most members starting June 20 (PDF) Explanation of lifestyle modification for weight loss drugs (PDF) Wyost SC, Jubbonti SC and Tyenne IV and SC to require prior authorization for most commercial members starting March 21 (PDF) e-referral system out of service for maintenance overnight March 16-17 (PDF) Update: Preferred product for Zynteglo for most commercial members starting April 19 (PDF) Udenyca Onbody to require prior authorization for most commercial members effective immediately (PDF) Update: Prior authorization requirements are changing for musculoskeletal pain management and spinal procedure codes (PDF) We’re changing how we manage Entyvio SC and Omvoh SC, starting March 1 (PDF) Additional drugs to require prior authorization for Medicare Advantage members starting April 1 (PDF) February 2024 Medicare Plus Blue PPO Provider Manual update coming in April 2024 (PDF) Update: Prior authorization requests for behavioral health services (PDF) Changes to the Gastric stimulation and Breast reconstruction questionnaires in the e-referral system (PDF) Update: Amtagvi to require prior authorization for most commercial members starting Feb. 29 (PDF) Additional preferred products for Soliris and Ultomiris for most commercial members starting April 1 (PDF) e-referral system out of service for maintenance overnight Feb. 17-18 (PDF) Don’t submit referrals for members with BCN point-of-service plans (PDF) Additional cardiology services to require prior authorization through Carelon for commercial members, starting May 11 (PDF) Call Blue Cross Behavioral Health if you need additional ABA units to bill approved authorizations (PDF) January 2024 Starting in March, we’ll no longer attach approval letters to Blue Cross commercial inpatient authorizations (PDF) We’re no longer mailing some letters related to Medicare Advantage inpatient admissions (PDF) Pemfexy to have step therapy requirements starting April 26 (PDF) Omvoh to have a site-of-care requirement for most commercial members starting May 1 (PDF) Include complete clinical information when submitting prior authorization requests for weight loss drugs (PDF) Updated: Entyvio, Omvoh and Wezlana to require prior authorization for most commercial members (PDF) Questionnaire changes in e-referral starting Jan. 28 (PDF) In the Blue Cross Behavioral Health provider portal, complete only the required fields when searching for a member (PDF) Starting March 1, some continuous glucose monitor products will require prior authorization (PDF) Updated: Alyglo to require prior authorization for most commercial members starting Jan. 18 (PDF) Cabenuva to have requirements for most commercial members starting May 1 (PDF) Email us if you’re having technical problems using the Blue Cross Behavioral Health provider portal (PDF) e-referral system out of service for maintenance overnight Jan. 20-21 (PDF) Continuity of care arrangements are expanded to Medicare Advantage members (PDF) Requirements changing for some medical benefit drugs for Medicare Advantage members (PDF) Blue Cross Behavioral Health to reinstate requirements; providers can submit authorization requests (PDF) January 2, 2024: Changes to ereferrals.bcbsm.com (PDF) Jan. 15 holiday closure: How to submit authorization requests for inpatient admissions (PDF)  Assisted reproductive technology benefit expanded, starting Jan. 1. 2023 (PDF)December 2023 December 28, 2023: Changes to ereferrals.bcbsm.com (PDF) December 5, 2023: Changes to ereferrals.bcbsm.com (PDF) NaviHealth to change its name to Home & Community Care (PDF) Updated: Two changes for the services managed by Blue Cross Behavioral Health (PDF) Avzivi and Ryzneuta to require prior authorization for most commercial members starting Jan. 1 (PDF) Casgevy and Lyfgenia to require prior authorization for Medicare Advantage members starting Jan. 2 (PDF) December-January holiday closures: How to submit authorization requests for inpatient admissions (PDF) Updated: Don’t submit prior authorization requests to Blue Cross Behavioral Health for dates of service on or after Jan. 1, until further notice (PDF) Prior authorization requests for Makena for Federal Employee Program members (PDF) Changes to Computed tomography...