CommercialAdministrativeMedium impact
Interfacility Transfer of a Registered Inpatient 11.01.18
Excellus BlueCross BlueShield·Emergency Medicine, Critical Care, Pediatrics +1 more·Miscellaneous
Effective date
Mar 19, 2026
We identified it
Jun 20, 2026
Summary
Excellus BlueCross BlueShield updated their policy on interfacility transfers of registered inpatients, reorganizing newborn transfer criteria from policy statements to guidelines but maintaining the same coverage requirements. The policy clarifies that both hospital stays are covered when specialized services are unavailable at the original facility and the receiving facility is the nearest participating provider with required capabilities.
Action Required
By March 19, 2026: Billing team should review interfacility transfer claims to ensure compliance with updated policy structure. Verify that prior authorization is obtained when required by member contracts before transferring patients between facilities. Update internal documentation to reflect that newborn transfer eligibility criteria are now in policy guidelines rather than policy statements.