Submit requests for commercial inpatient rehabilitation admissions and extensions only through e-referral

Beginning Jan. 1, 2023, we’ll require inpatient rehabilitation, or IPR, providers located in Michigan to submit prior authorization requests through the e-referral system and not by fax. This applies to requests for both Blue Cross Blue Shield of Michigan and Blue Care Network commercial members for:

• Initial admissions
• Additional days (extensions)

Currently, many inpatient rehabilitation providers are using the Blue Cross and BCN SNF/acute IPR assessment form to submit their prior authorization requests for inpatient rehabilitation services.

What's changing

Starting Jan. 1, 2023:

• We'll stop accepting faxed IPR requests as a general practice.
• We'll accept faxes only for urgent IPR requests when the e-referral system isn’t available. In those instances, fax the form using the instructions on the PDF document titled e-referral system planned downtimes and what to do.

If we receive a faxed form for an IPR admission or extension when the e-referral system is available, we won't accept the request. We'll notify IPR providers by fax or phone that they must submit the request through the e-referral system.

e-referral training

In October, we’ll schedule webinars for IPR providers so they can learn how to use the e-referral system. Watch for upcoming communications about these webinars.

Sign up for e-referral system

• To sign up for the e-referral system, follow the instructions on the Sign up for e-referral or change a user page.
• To learn how to use the e-referral system, refer to the Training Tools page, where you'll find the e-referral User Guide.

How to access the e-referral system

Access the e-referral system through our provider portal by following these steps:

1. Log in to availity.com.**
2. On the Payer Spaces menu, click on the BCBSM and BCN logo.
3. On the Applications tab, scroll down and click on the e-referral tile.

You’ll first need to register for access to our portal if you haven’t already done that. Refer to the Register for web tools webpage for instructions on how to:

• Register for access to Availity^®.
• Set up the e-referral tool within Availity.

Submit Medicare Advantage requests to naviHealth

naviHealth manages prior authorization requests for post-acute care admissions for our Medicare Plus Blue℠ and BCN Advantage℠ members.

**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.

naviHealth is an independent company that manages authorizations for post-acute care services for Blue Cross Blue Shield of Michigan and Blue Care Network members who have Medicare Advantage plans.