May 2024
Questionnaire changes in e-referral system
On March 31, 2024, we added one questionnaire and updated other questionnaires in the e-referral system.
We’ve updated the Authorization criteria and preview questionnaires document on the ereferrals.bcbsm.com website to reflect these changes.
As a reminder, we use our authorization criteria, our medical policies and your answers to the questionnaires in the e-referral system when making utilization management determinations on your prior authorization requests.
New questionnaire
We’ve added the following questionnaire to the e-referral system.
Questionnaire |
Opens for |
Updates |
Endoscopic bypass E&I trigger |
- Blue Care Network commercial
- BCN Advantage℠
|
Opens for procedure codes *43644 and *43645 |
Updated questionnaires
We’ve updated the following questionnaires in the e-referral system.
Questionnaire |
Opens for |
Updates |
Cosmetic or reconstructive surgery |
|
- No longer opens for BCN Advantage or Medicare Plus Blue℠
|
Dental general anesthesia |
|
- No longer opens for BCN Advantage
- Updated two questions
- Removed one question
|
Dental general anesthesia or dental services trigger |
|
- No longer opens for BCN Advantage
|
Dental services |
|
- No longer opens for BCN Advantage
|
Excess skin removal |
|
- No longer opens for BCN Advantage
|
Orthognathic surgery |
|
- No longer opens for BCN Advantage
|
Responsive neurostimulator / deep brain stimulation trigger |
- BCN commercial
- BCN Advantage
|
|
Surgical treatment for male gynecomastia |
- BCN commercial
- BCN Advantage
|
- Updated a question in the BCN commercial questionnaire
|
Preview questionnaires
Preview questionnaires show the questions you’ll need to answer in the e-referral system so you can prepare your answers ahead of time.
To find the preview questionnaires, see the document titled Authorization criteria and preview questionnaires.
You can access this document by going to ereferrals.bcbsm.com and doing the following:
- For Medicare Plus Blue: Click on Blue Cross and then click on Prior Authorization. Scroll down and look under the “Authorization information for Medicare Plus Blue members” heading.
- For BCN: Click on BCN and then click on Prior Authorization & Plan Notification. Scroll down and look under the “Authorization criteria and preview questionnaires for select services” heading.
Authorization criteria and medical policies
The Authorization criteria and preview questionnaires document explains how to access the pertinent authorization criteria and medical policies. |