We’ve enhanced the Authorizations & Referrals tool in Availity Essentials

In May 2024, we made an enhancement to the Authorizations & Referrals tool in our provider portal, Availity^® Essentials. This enhancement makes it easier for health care providers to determine if a Carelon-managed procedure code requires prior authorization for an in-state or out-of-state Blue Cross Blue Shield of Michigan commercial member.

Now, when you use the Authorizations & Referrals tool to look up the prior authorization requirement for a Carelon-managed procedure code, you’ll be directed to Carelon if prior authorization is required for the service for that specific member. If prior authorization isn’t required, you’ll see a message to that effect.

To access the Authorizations & Referrals tool:

1. Log in to our provider portal (availity.com).**
2. Click Patient Registration and then click Authorizations & Referrals.

For instructions on how to use the Authorizations & Referrals tool, see the document titled Determining prior authorization requirements for members.

You can also access this document by clicking the Determine prior authorization requirements for members tile on the left side of any page on our ereferrals.bcbsm.com website.

**Blue Cross Blue Shield of Michigan doesn’t own or control this website.

Availity^® is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal and electronic data interchange services.

Carelon Medical Benefits Management is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage prior authorizations for select services.