Blue Cross and BCN commercial will use Audaire Health provider portal to capture clinical outcomes on select therapies

Blue Cross Blue Shield of Michigan and Blue Care Network will use the Audaire Health™ provider portal to track and capture clinical outcomes for all Blue Cross commercial and BCN commercial members for select gene and cellular therapies, starting Oct. 1, 2022.

The data that health care providers enter in the Audaire provider portal will enable Blue Cross and BCN to capture and assess the clinical benefit of these therapies. The goal of collecting this data is to ensure member access to therapies while maintaining affordability.

Which therapies are affected?

Starting Oct. 1, Blue Cross and BCN commercial will capture clinical outcomes for the following therapies in the Audaire provider portal:

Note: Current requirements will continue to apply to these drugs, including prior authorization requirements.

What will change?

Starting Oct. 1:

• The first time Blue Cross or BCN approves a prior authorization request you submitted for one of these therapies, you (the requesting provider) must attest that you’ll enter clinical outcome information in the Audaire provider portal as requested by Blue Cross or BCN. Attestation is required for the therapies to be covered by a member’s benefit. (See “How should you prepare for this change?” below to learn more about attestation.)

Note: If you have patients for whom we approved an authorization request for one of these therapies prior to Oct. 1 and who currently have active coverage with Blue Cross or BCN, you’ll also be required to attest.

• For any member who is approved for one of these therapies, we’ll automatically add their basic information to the Audaire provider portal. We’ll also add basic information for any members who were approved for one of these therapies prior to Oct. 1.
• Providers will receive email reminders from Audaire on a regular basis to remind them to submit clinical information. The email messages will be sent by hello@audaire.com, and they’ll include a direct link to the portal for easy access.
• Providers can use either of these submission methods:
• Entering clinical information in the Audaire provider portal.
• Calling 512-643-5099. After stating your name, you’ll be connected to an Audaire representative, who can enter the clinical information on your behalf.

  Note: To get help entering information in the Audaire provider portal, call 512‑643‑5099 to schedule an appointment with an Audaire representative.

How should you prepare for this change?

You don’t need to take action.

The first time Blue Cross or BCN approves a prior authorization request you submitted for one of these therapies, an Audaire representative will reach out to you to set up a 30-minute phone call, during which they’ll:

• Create your Audaire Health profile, which will complete your attestation.
• Provide training on how to use the Audaire provider portal. 
• Answer your questions about the Audaire provider portal.

Note: An Audaire representative will also reach out to you if you have patients for whom we approved an authorization request for one of these therapies prior to Oct. 1 and have active coverage with Blue Cross or BCN.

Why are we making this change?

Blue Cross and BCN continually evaluate strategies to help manage drug costs.

Gene and cellular therapies hold significant promise for managing a wide range of diseases, but these therapies have high costs. Our goal is to ensure member access to therapies while maintaining affordability.

Questions?

If you have questions about this change, send them to Allison Olmsted, Pharm.D., at aolmsted@bcbsm.com.

Audaire Health is an independent company that provides select services to Blue Cross and BCN commercial members.