Get Blue Cross Complete Of Michigan Authorization Request Form

Prior authorization (PA) may be required via BCBSTX's medical management, eviCore® healthcare, Carelon Medical Benefits Management effective March 1, 2023 (formerly AIM) or Magellan Healthcare®. You can review how to submit PA or Notification requests and view PA statistical data here.

BCBSM requires prior authorization for services or procedures that may be experimental, not always medically necessary, or over utilized. Providers must submit clinical documentation in writing explaining why the proposed procedure or service is medically necessary.

Certified in Total - Indicates that the precertification is completed to the certified/review date. This will be a certification of admission only or a certification of medical necessity. If the precertification information is approved, a length of stay will be assigned.

Log in to Availity. Select Patient Registration menu option, choose Authorizations & Referrals, then Authorizations* Select Payer BCBSOK, then choose your organization. Select a Request Type and start request.

How do providers initiate a prior authorization request? Call 1-877-917-2583 (BLUE) or fax 1-844-407-5293. Hours are 8 a.m. to 7 p.m. Eastern time on weekdays; and 10 a.m. to 5 p.m. on weekends and holidays.

Then, select the Prior Authorization and Notification tool on your Link dashboard. Or, call 888-397-8129.

Requests for authorization for BCBS Michigan members can be submitted directly through your local Blue plans electronic portal via the Electronic Provider Access system (EPA). BCBSM encourages the use of the Electronic Provider Access system (EPA) to effectively and efficiently respond to your request.

o Select “Withdraw” • Click “Accept” to open the new window • Select the Cancel Reason (By Provider or By Member) • Add optional comments • Click “Cancel Request” Page 2 Successfully withdrawn requests will display the status of “Cancelled” in the Auth/Referral Dashboard.

CPT 93306 — the procedure ordered most frequently by cardiologists via eviCore's Advanced Imaging and Cardiology program — will no longer require authorization effective January 1, 2023.