For commercial LTACH requests, remember to submit information about 3 SNFs to avoid delays

When submitting prior authorization requests for admissions to long-term acute care hospitals, you must include information about three skilled nursing facilities you’ve already contacted that indicated they can’t provide the level of care the member requires.

This applies to LTACH placement requests for both Blue Cross Blue Shield of Michigan and Blue Care Network commercial members.

If the information that’s required about the three SNFs isn’t included when you submit the prior authorization request, we’ll consider your request incomplete. We’ll ask you to resubmit the request when the information is available. This delays the processing of the request.

Here’s the information we need about the three SNFs:

• Name of the SNF
• Phone number
• Name of the person you talked to
• Reason the SNF gave for not accepting the member

Be aware that:

• The three SNFs must be contracted with Blue Cross or BCN and located within 75 miles of the facility in which the member is currently a patient.
• Two of the three SNFs must be facilities that can accommodate members who need higher levels of care.

You can read more about these and other requirements in the document Blue Cross and BCN Local Rules for 2023 for post-acute care: Modifications of InterQual^® criteria.

You can access this document at ereferrals.bcbsm.com, on these webpages:

• Blue Cross Authorization Requirements & Criteria
• BCN Authorization Requirements & Criteria