Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan changes for 1/1/24
Kidney-only transplants to require prior authorization through the Human Organ Transplants Program
For dates of service on or after Jan. 1, 2024, hospital transplant financial coordinators must submit prior authorization requests for kidney-only transplants through the e-referral system for:
- Blue Cross Blue Shield of Michigan fully insured group and individual commercial members including BlueCard
- Blue Care Network fully insured group and individual commercial members
To learn how to access the e-referral system, see the Getting Started page of our ereferrals.bcbsm.com website. See the “outside of Michigan" information in the “Submit prior authorization requests" section.
For information about how to submit prior authorization requests for kidney-only transplants in the e-referral system, see the attached Blue Cross and BCN provider alert. For detailed instructions on working in the e-referral system, see the e-referral User Guide.
Click here for their provider alert for additional information.