Submitting appeals and peer-to-peer review requests in e-referral for inpatient hospital admission denials

Inpatient hospital providers can now submit requests for appeals and peer-to-peer reviews when an admission has been denied. This process is similar to the referral portal submission process already in place for initial authorization requests.

To submit an appeal or peer-to-peer request, go into the e-referral portal, locate the member and dates of service, and complete a short questionnaire for your specific request.

On March 13, 2024, at 1 p.m. Eastern time, we’re hosting a webinar – Submitting requests for appeals and peer-to-peer reviews in e-referral – where we’ll provide an overview of the process. We also have a mini course, which should take 15 minutes or less to complete, that shows you the step-by-step process for completing requests. You can view the mini course and sign up for the webinar on our Provider Training website.

Provider training website access

Provider portal users with an Availity^® Essentials account can access the provider training website by logging in to availity.com,** clicking on Payer Space in the top menu bar and then clicking on the BCBSM and BCN logo. Then click on the Applications tab, scroll down to the Provider Training Site tile and click on it.

You can also directly access the training website if you do not have a provider portal account: Provider training website.

If you need assistance navigating the provider training site, locating courses or signing up for the webinar, email ProviderTraining@bcbsm.com.

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

**Blue Cross Blue Shield of Michigan doesn't own or control this website.