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  • Bcn Behavioral Health Continuing Otr Form

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Payment. Treating clinician Type: Name: MD/DO Fully licensed psychologist LPC* Licensed SW CNP Other *Supervising provider name The authorization is to be entered for (select one): An individual -- See (a), below. and individual (Type 1) NPI: (b) Organization s name: and organizational (Type 2) NPI: Street address: Place of service City: ZIP code: Phone #: Date last seen Monthly Total time (approximate) in treatment with this practitioner: Less than 1 year Total c.

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Who we are. Blue Care Network of Michigan is a nonprofit health maintenance organization owned by Blue Cross Blue Shield of Michigan. Founded in 1998, BCN is Michigan's leading HMO with access in all 83 counties.

(5) Clinical review requirements have been expanded for FEP Blue Focus to include prior approval of high technology diagnostic imaging examinations (CT/MRI/PET) to promote patient safety, provide quality care and to support positive, cost effective outcomes.

Services That Require Prior Authorization Examples of services that commonly require prior authorization before being approved include: Diagnostic imaging (such as MRIs, CTs, and PET scans) Durable medical equipment (such as wheelchairs) Rehabilitation (like physical or occupational therapy)

Blue Care Network requires prior authorization for certain procedures to ensure that members get the right care at the right time and in the right location. BCN Prior authorization and plan notification - e-Referral e-Referral - Blue Cross Blue Shield of Michigan https://ereferrals.bcbsm.com › bcn › bcn-clinical_review e-Referral - Blue Cross Blue Shield of Michigan https://ereferrals.bcbsm.com › bcn › bcn-clinical_review

Federal Employee Program Members of the Federal Employee Blue Cross/Blue Shield Service Benefit Plan (FEP) are subject to different prior authorization requirements. For both outpatient procedures and treatment requiring an inpatient stay, call (800) 633-4581 to obtain prior authorization.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232