TurningPoint musculoskeletal authorization program to expand in January

As we communicated in previous issues, TurningPoint Healthcare Solutions LLC is expanding its surgical quality and safety management program for Blue Cross Blue Shield of Michigan and Blue Care Network members.

In this article, we’re sharing information about:

• The procedures that are affected by the TurningPoint program expansion
• Accessing the TurningPoint Provider Portal
• Submitting retrospective authorization requests for procedure codes for which authorization management will transition from eviCore healthcare^® or Medicare Plus Blue℠ PPO Utilization Management to TurningPoint
• Registering for webinar training sessions

Procedures affected by the TurningPoint program expansion
Starting on Dec. 1, 2020, providers should submit authorization requests for the following procedures to TurningPoint for dates of service on or after Jan. 1, 2021:

• Pain management procedures — For all Blue Cross fully insured commercial groups, select Blue Cross administrative service contract commercial groups, all Medicare Plus Blue members, all BCN commercial members and all BCN Advantage℠ members
• Joint replacement surgeries and other related arthroscopic procedures — For all Blue Cross fully insured commercial groups and select Blue Cross ASC commercial groups
• Spinal procedures — For all Blue Cross fully insured commercial groups, select Blue Cross ASC commercial groups and all Medicare Plus Blue members

TurningPoint Provider Portal
The most efficient way to submit authorization requests is through the TurningPoint Provider Portal.

Provider offices can access the TurningPoint Provider Portal by following these steps:

1. Visit bcbsm.com/providers and log in to Provider Secured Services.
2. Click on the Musculoskeletal Service Authorizations through TurningPoint link.
3. Enter your NPI.

If you’re having trouble accessing the TurningPoint Provider Portal using this process, contact Blue Cross’ Web Support Help Desk at 1-877-258-3932.

For out-of-state providers: Log in to your local plan's website and select an ID card prefix from Michigan. This will take you to the Blue Cross Blue Shield of Michigan website. You can then click on the Musculoskeletal Service Authorizations through TurningPoint link and enter your NPI. You may need to complete a one-time registration process with TurningPoint; after you register, you’ll have access to the Musculoskeletal service authorization through TurningPoint link in Provider Secured Services.

In addition, any provider can register for direct access to the TurningPoint Provider Portal through the TurningPoint website. For more information, see “How do I register for direct access to the TurningPoint Provider Portal?” in the Musculoskeletal procedure authorizations: Frequently asked questions for providers document.

Submitting retrospective authorization requests
For Blue Cross’ fully insured commercial groups and Medicare Plus Blue members, the expansion of the TurningPoint program affects spine procedures that are managed by eviCore for dates of service prior to Jan. 1, 2021. In addition, for all Blue Cross fully insured commercial groups, select Blue Cross ASC commercial groups, all Medicare Plus Blue members, all BCN commercial members and all BCN Advantage members, the expansion affects pain management procedures managed by eviCore for dates of service prior to Jan. 1, 2021. For all these services, you’ll be able to submit retrospective authorization requests to eviCore through April 30, 2021.

For Medicare Plus Blue members, the expansion of the TurningPoint program also affects some pain management procedures that are managed by Medicare Plus Blue Utilization Management for dates of service prior to Jan. 1, 2021. You’ll be able to submit retrospective authorization requests to Medicare Plus Blue Utilization Management through March 31, 2021.

TurningPoint webinar training sessions
We’re offering TurningPoint webinar training sessions. Click on a link below to register.

Professional provider training — Includes information about TurningPoint's clinical model and operational changes, along with information about using the TurningPoint Provider Portal.

Facility training — Includes information about TurningPoint's clinical model and operational changes and the facility verification process.

Portal training — Includes information about using the TurningPoint Provider Portal.

Additional information
We recently moved all procedure codes that are managed by TurningPoint into a single document titled Musculoskeletal procedure codes that require authorization by TurningPoint.

You can also find information about TurningPoint on the Musculoskeletal Services pages on the ereferrals.bcbsm.com website:

• Blue Cross Musculoskeletal services page
• BCN Musculoskeletal services page