Additional Resources
Note: The requirements above don’t apply to members with BCN 65 plans.
How to submit prior authorization requests
To learn how to submit requests, see our Getting Started page.
Submit requests before providing services.
Resources
- Procedure codes that require authorization by eviCore healthcare (PDF) — Lists procedure codes for which eviCore manages prior authorizations
- Services reviewed by eviCore for Blue Cross and BCN (PDF) — Outlines the types of services for which eviCore manages prior authorizations, how to submit requests, where to find clinical criteria and guidelines, and more
- Outpatient rehabilitation services: Frequently asked questions (PDF)
- Tips about eviCore Authorizations for BCN Members (PDF)
- Suggestions for the Efficient Utilization of Therapy and Physical Medicine Services (PDF)
- Tips for improving treatment efficiency (PDF)
- Outpatient PT, OT and ST, and physical medicine services by chiropractors and athletic trainers: For authorization determinations (PDF) — Includes information about utilization management programs
- eviCore Physical Therapy Practitioner Performance Summary and Provider Category FAQs* (PDF)
- eviCore Practitioner Performance Summary and Utilization Management Categories* (PDF)
- U-M Premier Care Primary (Major) Diagnosis Codes for Therapies (PDF)
*Clicking this link means that you're leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website. While we recommend this site, we're not responsible for its content.
eviCore healthcare ® is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage prior authorizations for select services.
Contact
Frequently accessed documents
- Care and utilization management programs: Overview for providers (PDF)
- e-referral Quick Guide (PDF)
- Provider resource guide at a glance (PDF)
- Provider Manuals
Additional resources
- Blue Cross and BCN Provider Systems and Web Resources Guide (PDF)
- Log in to our Provider Portal
- bcbsm.com/providers
- Find a doctor or hospital
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