BCN Provider Manual - Chapter 8: Utilization Management

Contents care Management 2018 care ManagementBCN Provider ManualContentsHyperlinks to important information ..8-1 Overview of BCN Utilization Management ..8-2 Managing BCN members care ..8-5 The BCN referral process ..8-7 BCN authorization requirements ..8-18 Requests requiring clinical information ..8-24 Referrals and authorizations summary ..8-27 Procedures reviewed by eviCore for BCN ..8-30 blue Elect Plus Self-Referral s Medicare products ..8-34 Other BCN products with Provider networks ..8-37 BCN 65 and secondary s Choice ..8-40 Guidelines for observations and inpatient hospital admissions ..8-41 Guidelines for transitional care ..8-49 Emergency room and urgent care services ..8-53 BCN case Management activities ..8-55 Coordination of care ..8-61 Continuity of care Management 2018 BCN a resource for physicians.

Blue Care Network has produced this document in accordance with guidelines, policies and procedures current with the date noted on this page. Blue Care Network reserves the right to update, modify, change or replace any portion of this document to reflect later guidelines, policies or procedures. The manual is an extension of the provider ...

Tags:

  Network, Care, Blue, Blue care network

Information