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September 2018

We’ve added ‘All Cases’ search field to e-referral; tips for reviewing the results of medical drug authorization requests

On Aug. 6, 2018, we added an “All Cases” search box to e-referral. By checking the “All Cases” box, health care providers can search beyond the provider set to see any case the member has in the e-referral system. That includes vendor-created cases.

Previously, providers could only search for cases within their provider set.

This search field is for all lines of business but doesn’t apply to behavioral health services.

The screenshot below shows search results when the “All Cases” box (outlined in blue) isn’t checked.

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The screenshot below shows search results when the “All Cases” box is checked. [Kyle, please blur the following on the screenshot below: Patient ID; Reference ID (1st column); Patient (3rd column); Date of Birth (5th column)]

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An advantage of this change is that if a provider can’t find a case under the NPI, then he or she can now search under the member’s name.

If you’re looking up a specialty medical drug prior authorization for a case you’re not associated with, simply click the “All Cases” box.

Medical drug authorization requests

In the e-referral system, authorization request results for drugs covered under the medical benefit for Blue Cross PPO members are different from other types of authorization request results. To help you navigate these differences, we put together a tip sheet titled Reviewing e-referral results: Medical drug authorization requests. The tip sheet is located on the Medical Benefit Drugs – Pharmacy page in the Blue Cross section of our ereferrals.bcbsm.com website.

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