Use updated forms for post-acute care prior authorization requests for commercial members

Providers should use our updated and aligned forms when submitting prior authorization requests for post-acute care for Blue Cross Blue Shield of Michigan and Blue Care Network commercial members.

Among other changes, we combined the Blue Cross and BCN forms, which were previously separate, so providers can now use the same form to submit post-acute care requests for both Blue Cross and BCN commercial members.

Follow the instructions on each form for completing and submitting it:

• Skilled nursing facility and acute inpatient rehabilitation form. Attach this form to the case in the e-referral system: For skilled nursing facility, or SNF, and for acute inpatient rehabilitation, or IPR, requests, attach the completed form and the required documentation to the case in the e-referral system.
• Long-term acute care hospital form. Fax this form: For long-term acute care hospital, or LTACH, requests, fax the completed form along with the required documentation to one of the numbers shown on the form.

In July, we posted the forms in the following locations:

• On the For Providers: Forms and Documents page at bcbsm.com/providers.
• On our ereferrals.bcbsm.com website, on the BCN Utilization Management Forms page and on the Blue Cross Authorization Requirements & Criteria page in the “For Blue Cross commercial members” section.
• In the Secure Provider Resources area of our provider portal at availity.com.** On the Forms menu, click on Assessment.

In addition to combining the Blue Cross and BCN forms, we updated the forms to make them easier to submit:

• We included more fields so providers can now enter more complete information on each form.
• We clarified the instructions for submitting the requests. (See the instructions on the form.)

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