Starting June 1, requests for commercial LTACH admissions and extensions must be submitted through e-referral

Long-term acute care hospitals, or LTACHs, in Michigan must submit prior authorization requests through the e-referral system and not by fax, starting June 1, 2023. This applies to requests for our Blue Cross Blue Shield of Michigan and Blue Care Network commercial members for:

• Initial admissions
• Additional days (extensions)

Many LTACH providers in Michigan currently use the Blue Cross and BCN LTACH Assessment Form to fax their prior authorization requests.

For Michigan providers

Starting June 1, 2023, we’ll accept faxes only for urgent requests and when the e-referral system isn’t available. Follow the instructions on the document titled e-referral system maintenance times and what to do.

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

For non-Michigan providers

LTACH providers outside of Michigan can either:

• Continue to submit requests by fax.
• Submit requests through the e-referral system. For additional information and steps to access the e-referral system, refer to the non-Michigan providers section of the document titled Determining prior authorization requirements for members. Prior authorization is required for LTACH stays.

Training opportunities

We’ll schedule webinars in May on how to use the e‑referral system. Watch for upcoming communications.

Sign up now to use e-referral system

Get information on our ereferrals.bcbsm.com website as follows:

• To sign up, 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:

• Log in to availity.com.**
• Click on Payer Spaces on the menu bar and then click on the BCBSM and BCN logo.
• 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.

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

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.