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Get MI BCBS Acute Inpatient Assessment Form 2012

585 Or E-FAX/E-Mail to AcutePrecertification1@bcbsm.com Include hospital admission H&P and PM&R consultation notes (as applicable) A nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association Facility and provider must participate with local BCBS plan or member may incur sanctions. Precertification does not guarantee payment. Please verify eligibility and benefits prior to request. Complete every field unless otherwise noted. Information must be legible. Place.

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