Reminder: Get easy access to information about care management, utilization management programs

In November 2021, we published the Care management and utilization management programs: Overview for providers document to help you navigate our care management and utilization programs more easily.

Since then, we’ve updated the overview and the documents linked within it to reflect changes that went into effect on Jan. 1, 2022. We’ll continue to make updates as information changes.

This easy-to-use, one-page document tells you what you need to know about these two categories of programs:

• Care management — Provides patient support by identifying patients with health risks and working with them to improve or maintain their health.
  
• Utilization management — Focuses on ensuring that patients get the right care,  at the right time, in the right location, through the authorization process.

The programs vary based on member coverage and may be administered by Blue Cross Blue Shield of Michigan and Blue Care Network staff or by contracted vendors.

In addition to being able to access the document from the link in the first paragraph of this article, you can find it by going to ereferrals.bcbsm.com and following these steps:

• Click on the Quick Guides link in the left-hand column (under Additional Resources).
• Click on the Care management and utilization management programs: Overview for providers link.

For more details, see the December 2021 Record article or the January-February 2022 BCN Provider News article (Page 11).