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May 2022
Reminder: Starting March 1, we’ve aligned our Local Rules for acute inpatient medical admissionsFor acute inpatient medical admissions of members with certain conditions, authorization requests should be submitted only after the member has spent two days in the hospital. This update to our Local Rules went into effect for all members admitted to Michigan hospitals on or after March 1, 2022. This includes Blue Cross Blue Shield of Michigan and Blue Care Network commercial members, as well as Medicare Plus Blue℠ and BCN Advantage℠ members. Note: For non-Michigan hospitals, this update applies only to Medicare Plus Blue members. About observation orders Some hospitals have asked whether an observation order is required when billing Blue Cross or BCN for observation. Blue Cross and BCN don’t require an observation order when reimbursing an observation claim. This applies to all lines of business: Blue Cross commercial, Medicare Plus Blue, BCN commercial and BCN Advantage. Additional information
We communicated about this change in our provider newsletters previously. Refer to these articles:
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