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Blue cross michigan precertification form 2026

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  1. Click ‘Get Form’ to open the blue cross michigan precertification form in the editor.
  2. Begin by filling out the 'Patient Information' section. Enter the patient's name, date of birth, policy number, and contact details including address and phone number.
  3. In the 'Precertification' section, indicate the type of admission (ER admit, direct admit, elective admit) and provide the estimated length of stay along with the admission date.
  4. Complete the 'Facility Information' fields by entering the facility name, NPI number, and contact details. Ensure all information is accurate for processing.
  5. For recertification requests, specify the number of days requested and provide current estimated length of stay along with any relevant medical history or surgical procedures.
  6. Review all entries for completeness. Incomplete submissions will be returned unprocessed. Once satisfied, save your changes and follow instructions to fax it as required.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Questions? During the credentialing or recredentialing process, you can ask questions about the status of your application, ask to review information submitted to support your application and correct anything in error by calling us at 1-800-822-2761.
Prior authorizationsometimes called preauthorization or precertificationis a health plan cost-control process by which physicians and other health care providers must obtain advance approval from a health plan before a specific service is delivered to the patient to qualify for payment coverage.
Blue Cross Blue Shield of Michigan and Blue Care Network require prior authorization for certain benefits. This means we need to review a service to be sure it is medically necessary and appropriate.
Blue Cross Blue Shield of Michigan (BCBSM) is an independent licensee of Blue Cross Blue Shield Association.
Use the Precertification Lookup Tool accessed through Payer Spaces in Availity. Call Provider Services at 1-844-421-5662.

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People also ask

To verify coverage or benefits or determine pre-certification or pre-authorization requirements for a particular member, call 1-800-676-BLUE or send an electronic inquiry through your established connection with your local Blue Plan.
Providers can request a coverage determination (prior authorization, step therapy, formulary exception or quantity limit exception) by phone at 1-800-437-3803 or by using the information in the Medicare Plus Blue PPO section of the For Providers Drug Lists page on bcbsm.com/providers.
General support Call the number on the back of your member ID card or call 1-313-225-9000. Members can also log in to find health plan information and helpful resources or to request a new ID card.

blue cross blue shield of michigan prior authorization form

Blue Cross Blue Shield Customer Service Directory

You must contact Blue Cross to obtain precertification for non-emergency inpatient services. You must submit a claim

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