Updated e-referral system questionnaires released for Medicare Plus Blue, BCN in February 2020

In the January issue of The Record, we listed the questionnaires that we expected to release in the e-referral system by Jan. 26, 2020.

Most of the questionnaires listed in the articles were updated on Dec. 8, 2019. However, we had to postpone the release of the following questionnaires to Feb. 2:

• Breast reduction — We combined the Breast reduction, adult and the Breast reduction, adolescent questionnaires for BCN and BCN Advantage^SM members into a single questionnaire for both adult and adolescent members.
• Spinal cord stimulator or epidural or intrathecal catheter (trial or permanent placement) — We replaced this questionnaire with the following three questionnaires:
• Spinal cord stimulator — For BCN members
• Spinal cord stimulator — For Medicare Plus Blue^SM and BCN Advantage members
• Intrathecal catheter — For Medicare Plus Blue, BCN and BCN Advantage members

In addition, we updated the following questionnaire Feb. 2:

• Sleep studies — Opens only for BCN and BCN Advantage members

Here’s some additional information you need to know:

• We updated the preview questionnaires, authorization criteria and medical policies on the ereferrals.bcbsm.com website for the questionnaire updates.
• We use our authorization criteria and medical policies and your answers to the questionnaires when making utilization management determinations on your authorization requests.
• For all of these services, you can access preview questionnaires at ereferrals.bcbsm.com. The preview questionnaires show the questions you’ll need to answer in the actual questionnaires that open in the e-referral system. This can help you prepare your answers ahead of time. To find the preview questionnaires:
• For Medicare Plus Blue: Click on Blue Cross and then click on Authorization Requirements & Criteria. In the Medicare Plus Blue PPO members section, look under the Authorization criteria and preview questionnaires — Medicare Plus Blue PPO heading.
• For BCN: Click BCN and then click on Authorization Requirements & Criteria. Scroll down and look under the Authorization criteria and preview questionnaires heading.