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August 2023

Submit prior authorization requests for non-emergency air ambulance flights through the Alacura PreAuth Portal

Prior to each flight, Michigan and non-Michigan health care providers must submit a prior authorization request for non-emergency air ambulance services. This requirement applies to Blue Cross Blue Shield of Michigan commercial and Blue Care Network commercial members.

Michigan’s prior authorization law requires providers to submit these requests electronically to Alacura Medical Transport Management.

Submit requests using the web form on the Alacura PreAuth Portal. To learn how to access the web form and for detailed information about completing the form, see the document titled Non-emergency air ambulance prior authorization program: Overview for Michigan and non-Michigan providers.

If you can’t access the Alacura PreAuth Portal, call Alacura or fax the Air ambulance flight information (non-emergency) form to Alacura. You can find information about these alternate submission methods in the document linked above.

You can access the overview document and the form discussed above from the Blue Cross Authorization Requirements & Criteria page or the BCN Authorization Requirements & Criteria page on the ereferrals.bcbsm.com website.

Alacura Medical Transport Management is an independent company that manages the authorization of non-emergency flights for Blue Cross Blue Shield of Michigan and Blue Care Network members who have commercial plans.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2022 American Medical Association. All rights reserved.