Submit prior authorization requests for human organ transplants through e-referral, not fax, starting June 1

Beginning June 1, 2023, we’ll require providers located in Michigan to submit prior authorization requests for human organ transplant procedures through the e-referral system and not by fax.

This applies to requests for Blue Cross Blue Shield of Michigan commercial, Blue Care Network commercial and BCN Advantage℠ members having bone marrow and specified solid organ transplant procedures.

This change doesn’t apply to Medicare Plus Blue℠ members.

Also, it doesn’t include kidney transplant procedures except for Blue Cross and Blue Shield Federal Employee Program^® members, for whom kidney transplant procedures require prior authorization.

Currently, most providers are faxing these requests to us.

Notice for hospital transplant financial coordinators

To prepare for this change, hospital transplant financial coordinators must contact their Availity^® administrator so the administrator can:

• Give the coordinator access to our provider portal (availity.com).**
• Set up the e-referral tool within Availity for the coordinator.

We’ll contact each coordinator by email to help them determine who their Availity administrator is. In addition, we’ll schedule webinars in May so the coordinators can learn how to use the e-referral system.

We’ll notify the coordinators directly about registering for the webinars.

Availity is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal services.

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