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BCN Provider Manual - Chapter 8: Utilization Management

Page i BCN Provider Manual (BCN commercial and BCN Advantage) Revised February 2022 BCN Provider Manual 2022 BCN commercial and BCN AdvantageSM Utilization Management This Chapter is subject to change. To ensure that you review the most current version, we strongly discourage you from relying on printed versions. Chapter contents Important! Click a link below to go to that page in the Chapter . Hyperlinks to important information .. 1 Links used in this Chapter .. 1 How to find billing / claim information .. 1 Overview of BCN Utilization Management .. 2 Scope of Chapter .. 2 Program goal .. 2 Utilization Management department services .. 2 Contacting BCN Utilization Management .. 3 Monitoring Utilization .. 3 Affirmation statement .. 4 Managing BCN members care .. 4 Focus on primary care .. 4 Specialist s role .. 4 BCN support .. 4 Referral to BCN-contracted specialists (BCN commercial only) .. 4 Access to women s health services through Woman s Choice .. 5 Regional referral differences (BCN commercial only).

Page i BCN Provider Manual (BCN commercial and BCN Advantage) Revised February 2022 . BCN Provider Manual – 2022 BCN commercial and BCN AdvantageSM. Utilization Management

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Transcription of BCN Provider Manual - Chapter 8: Utilization Management

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