BlueCard^® connection: Which Blue plan do I contact to request an authorization?

All providers should contact the Blue plan where the member is enrolled to request:

• A required authorization

• Prior approval for any admission, service or treatment plan

When calling the toll-free BlueCard number (1-800-676-2583), you’ll be asked to provide the member’s three-letter alpha prefix found on his or her ID card. This alpha prefix will route you to the member’s home plan.

The first prompt includes information on your patient’s eligibility and benefits. The second prompt provides information on services that require an authorization and the option to initiate the authorization.

The authorization prompt should also be used:

• When a provider requests prior approval for a service or treatment plan that may not be required but is requested by the provider

• To request a retro-authorization or to appeal the plan’s decision or to extend a stay or treatment plan

Plans also make available to all providers the option to initiate an electronic authorization via the Electronic Prior Authorization tool when an electronic authorization is available to providers in their home plan. In Michigan, the Electronic Prior Authorization link is available on our secured provider portal.

For more information on the BlueCard program, including links and articles on online tools, reference the BlueCard chapter of the online provider manuals.

If you’re experiencing issues with the information provided in the BlueCard chapter of the online manual — or if you’d like more information on a particular topic — contact your provider consultant.

Want to suggest a topic to be covered in this series? Send an email to ProvComm@bcbsm.com and put “BlueCard series” in the subject line.