OncoHealth manages our Oncology Value Management program, starting Jan. 1

As a reminder, OncoHealth will manage authorizations for oncology and supportive care drugs for most Blue Cross Blue Shield of Michigan commercial and Blue Care Network commercial members and all Medicare Plus Blue℠ and BCN Advantage℠ members through the Oncology Value Management program. This applies to dates of service on or after Jan. 1, 2025.

For additional information, see the October Record and the November Record.

Start submitting prior authorization requests to OncoHealth on Jan. 1

On Jan. 1, 2025, health care providers will be able to submit prior authorization requests in the OncoHealth Provider Portal, OneUM™, through Availity Essentials™.

To access the OncoHealth Provider Portal:

1. Log in to the Blue Cross and BCN provider portal at availity.com.**
2. Click on Payer Spaces in the menu bar, and then click on the BCBSM and BCN logo.
3. Click on the OncoHealth Provider Portal tile in the Applications tab.

Members who started receiving treatment before Jan. 1, 2025, can continue to receive treatment under their approved authorization until it expires. Authorization isn’t required from OncoHealth unless:

• There’s a change to the existing treatment plan on or after Jan. 1, 2025.
• Treatment extends past the authorization end date.

Attend or view a webinar

Providers who submit prior authorization requests for oncology drugs should attend a live webinar to learn more.

The webinar will:

• Provide an overview of the services that will require prior authorization by OncoHealth
• Explain how to submit prior authorization requests, including the supporting documentation to include with requests
• Provide a demonstration of OncoHealth’s prior authorization portal
• Review the prior authorization workflow

If you haven’t attended a webinar already, there’s still time. Click one of the links below to register. 

If you can’t attend a live webinar, you can view a recorded webinar. To access it, log in to our Provider Training site and search for “oncology.”

To access the Provider Training site:

1. Log in to our provider portal at availity.com.**
2. Click on Payer Spaces in the menu bar, and then click on the BCBSM and BCN logo.
3. Click on the Provider Training Site tile in the Applications tab.
4. Select an organization, and click Submit.

If you have issues accessing or navigating the site, email ProviderTraining@bcbsm.com.

Additional information

For additional information, see the document Oncology Value Management program through OncoHealth: Frequently asked questions for providers.

You can find the FAQ document, lists of medical benefit oncology and supportive care drugs that require prior authorization, and more on the following pages on ereferrals.bcbsm.com:

• Blue Cross Medical Benefit Drugs
• BCN Medical Benefit Drugs

** 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 and electronic data interchange services.

OncoHealth is an independent company supporting Blue Cross Blue Shield of Michigan and Blue Care Network by providing cancer support services.