CommercialPrior AuthHigh impact
Register for training about prior authorization changes for radiation oncology, radiopharmaceuticals
BCBS Michigan·MI · Radiation Oncology, Nuclear Medicine, Oncology·Prior Authorization
Effective date
Sep 1, 2026
We identified it
Jun 26, 2026
Summary
Effective September 1, 2026, radiation oncology services (including proton beam therapy) and radiopharmaceuticals will be managed through the Oncology Value Management program administered by OncoHealth. This represents a shift in prior authorization requirements and management for these services. OncoHealth is hosting training webinars in August and September 2026 to educate providers on the new program.
Action Required
Before September 1, 2026: Billing team must establish new prior authorization workflow with OncoHealth for all radiation oncology and radiopharmaceutical claims. Specific actions: (1) Register providers/billing staff for OncoHealth training webinars (Aug 13, Aug 18, Aug 27, Sept 3, or Sept 9 at oncohealth.us/training-bcbsmi); (2) Update billing system to route radiation oncology and radiopharmaceutical prior authorization requests to OncoHealth instead of current process; (3) Train billing staff on OncoHealth's authorization procedures, turnaround times, and appeal processes; (4) Update internal claim submission protocols and encounter forms to reflect new OncoHealth contact and requirements; (5) Communicate change to radiation oncology and nuclear medicine providers. Failure to route claims through OncoHealth starting Sept 1, 2026 will result in claim denials and authorization delays.