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June 2016
Reminder: Medicare Plus BlueSM post-acute care prior authorization process changing June 1
Effective June 1, 2016, prior authorization for inpatient admissions to skilled nursing facilities, long-term acute care facilities and inpatient rehabilitation facilities for Medicare Plus Blue members will be handled by eviCore healthcare.
EviCore healthcare is a national specialty benefit management company that focuses on managing quality and use for individual patients.
This process is for Blue Cross Blue Shield of Michigan members residing in Michigan using Michigan providers for post-acute care services.
Process change
For
dates of service on or after June 1, 2016, hospitals will need to contact eviCore at 1-877-917-2583 (BLUE) to request prior authorization for skilled nursing facility, long-term acute care or inpatient rehabilitation facility admissions. EviCore healthcare will authorize the admission and length of stay.
The fax form is located on the eviCore implementation site for Blue Cross**, along with a list of frequently asked questions. The fax number is 1-844-407-5293. Program and training information is located on the implementation site under Provider Resources.
In the case that a prior authorization request is denied, you’ll have an opportunity for a peer-to-peer conversation. If you have any questions, contact your provider consultant.
Web orientation sessions
To attend an online Web orientation session, you need to register in advance. Each session is free and will last around one hour. The orientation sessions, which continue in June, are below.
- 8 a.m. Wednesday, June 1
- Noon Thursday, June 2
- 4 p.m. Friday, June 3
- 4 p.m. Tuesday, June 7
- 8 a.m. Wednesday, June 8
- Noon Friday, June 10
All session times are Eastern time. Note: WebEx may display Central time.
For complete instructions on training for the new process, click here.
**Blue Cross Blue Shield of Michigan does not own or control the content of this website.
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