Transcription of Provider Preauthorization and Precertification Requirements
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Provider Preauthorization and Precertification Requirements
Provider Preauthorization and Precertification Requirements For blue cross PPO (commercial) and Medicare Plus BlueSM PPO members Revised Nov. 29, 2021 SPECIAL NOTE: Clinical review Requirements temporarily suspended for admissions to skilled nursing facilities from hospitals in certain states. See Section 4: Inpatient Admissions for more information. Table of Contents 1. blue cross blue shield of michigan Definitions .. 2 2. Behavioral health .. 2 blue cross blue shield of michigan Commercial Products (Non-Medicare) .. 2 Medicare Plus BlueSM PPO .. 3 3. Human Organ Transplants .. 4 blue cross blue shield of michigan Commercial Products (Non-Medicare).
Directions Behavioral Health on behalf of Blue Cross Blue Shield of Michigan. Groups with other service providers can be reviewed on the BCBSM Mental Health Carve-Out List. Call New Directions at 800-762-2382 to obtain precertification and preauthorization information. If medical records are requested for review, send the records to:
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