CommercialPrior AuthMedium impact
Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan changes for 1/1/24
Blue Cross Blue Shield of Rhode Island·MI · Nephrology, Urology·Physician / Facility
Effective date
Jan 1, 2024
We identified it
Jun 19, 2026
Summary
Starting January 1, 2024, Blue Cross Blue Shield of Michigan and Blue Care Network require prior authorization for kidney-only transplants through their e-referral system. Hospital transplant financial coordinators must submit these requests for fully insured commercial members.
Action Required
By January 1, 2024: Hospital transplant financial coordinators must begin submitting prior authorization requests for kidney-only transplants through the BCBSM e-referral system at ereferrals.bcbsm.com. Access the Getting Started page to learn the system and review the User Guide for detailed instructions. Failure to obtain prior authorization will result in claim denials.