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July 2023
We’ve made questionnaire changes in e-referral systemWhat you need to know Several questionnaires in the e-referral system have been updated. Providers can preview questionnaires on ereferrals.bcbsm.com. In May, we updated and removed questionnaires in the e-referral system, as well as the corresponding preview questionnaires on the ereferrals.bcbsm.com website. We use our authorization criteria, our medical policies and your answers to the questionnaires in the e-referral system when making utilization management determinations on your authorization requests. Updated questionnaires We updated the following questionnaires on the dates specified below:
In addition, we limited the number of units providers can request per procedure code to two for endovascular intervention. This change affects Medicare Plus Blue℠, BCN commercial and BCN Advantage℠ members. Removed questionnaire We removed the Cholecystectomy (laparoscopic) questionnaire for BCN commercial and BCN Advantage members. Plan notification will be required for procedure codes *47562, *47563 and *47564, but no clinical review will be performed. Preview questionnaires Preview questionnaires show the questions you’ll need to answer in the e-referral system so that you can prepare your answers ahead of time. To access them, go to ereferrals.bcbsm.com and:
Authorization criteria and medical policies The Authorization Requirements & Criteria page explains how to access the pertinent authorization criteria and medical policies. |
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