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June 2022
Private duty nursing will soon require prior authorizationStarting Oct. 1, 2022, private duty nursing agencies will have the opportunity to participate in Blue Cross Blue Shield of Michigan’s Traditional and TRUST PPO (commercial) network. Participating agencies can receive direct reimbursement for covered services within the scope of their licensure. This change will affect Blue Cross benefit plans that cover services these providers are licensed to provide. To find out if a member has coverage, check our provider portal for member benefits and eligibility, or call Provider Inquiry at 1‑800‑344‑8525. Requirements Private duty nursing services will require prior authorization effective for dates of service beginning Oct. 1, 2022. We’ll begin accepting requests for prior authorization starting Sept. 1, 2022. Prior authorizations will be submitted through e-referral. Stay tuned More information about this program, including enrollment, claims submission requirements and available training, will be coming soon. |
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