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May 2020
Update: Providers must submit authorization requests to TurningPoint for musculoskeletal surgical procedures scheduled on or after July 1 for certain members
As we reported in previous issues of The Record, providers will need to submit authorization requests through TurningPoint Healthcare Solutions LLC for Blue Care Network commercial, BCN AdvantageSM and Medicare Plus BlueSSM PPO members.
Due to the COVID-19 pandemic, we’re delaying the date on which TurningPoint will begin managing authorizations. TurningPoint will now begin managing authorizations for dates of service on or after July 1, 2020.
Providers must submit authorization requests for all surgical procedures related to musculoskeletal conditions to TurningPoint. This is effective for procedures scheduled on or after July 1, 2020.
See this article in the March Record for detailed information.
You’ll be able to submit authorization requests to TurningPoint starting on June 1, 2020. For information about the duration of authorizations during the COVID-19 pandemic, see the Changes to authorization durations for elective and non-urgent procedures, including PT, OT and ST, during the COVID-19 pandemic message that we posted to our public website at bcbsm.com/coronavirus.
We’ll continue to offer webinar training for providers and facilities.
Use the links below to register for webinars:
Important information for facilities
Facilities should have an authorization before scheduling surgery.
Facility providers won’t be able to access the TurningPoint portal until fourth-quarter 2020 to get a status on authorization requests. In the meantime, we’re recommending that the ordering physicians secure the required authorization and provide the authorization numbers to the rendering facilities or providers.
Facilities can look up the status of an authorization request by checking on ereferrals.bcbsm.com. The authorization will show in our system one business day after TurningPoint has made a decision. To check the status of an authorization request directly with TurningPoint, call 1-833-217-9670.
Include only procedure codes authorized for musculoskeletal procedures on your claims
For inpatient professional claims, make sure to include only the procedure codes TurningPoint authorized on your claim.
On a quarterly basis, Blue Cross Blue Shield of Michigan and Blue Care Network will review paid inpatient claims from professional providers to ensure that the procedure codes on the claims match the procedure codes TurningPoint authorized. If we find overpayments because the claim included codes that TurningPoint didn’t authorize, we’ll pursue payment recoveries as necessary.
You can request that TurningPoint add procedure codes to an authorization, but you must do this prior to submitting your claim. For more information about updating procedure codes on an authorization, see the FAQ document referenced below.
Where to find more information
For more information about TurningPoint, see the Blue Cross or BCN Musculoskeletal Services pages on the ereferrals.bcbsm.com website. On these pages, you can find procedure codes for orthopedic and spinal procedures managed by TurningPoint. The links are below:
You can also refer to the frequently asked questions document on these pages.
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