This article is for ambulatory surgical centers and acute care hospitals caring for our members
As a reminder, you must fax us requests to change the level of care on approved authorizations. For example, if a member has undergone a pre-authorized surgical day care procedure, such as a total hip replacement, and they unexpectedly need to be admitted inpatient, you must fax Blue Cross a request to change the level of care. Please do not submit an urgent request for a new authorization as there is already an approved authorization on file.
Please indicate “level of care change request” on your cover sheet and fax the below information to us:
- Original authorization number
- Member name, date of birth, and ID number
- Level of care that you are requesting (inpatient or outpatient)
- Admit date (for inpatient) or start date (for outpatient)
- Name and NPI of MD and facility
- Facility address (if outside of Massachusetts)
- Diagnosis and CPT/HCPCS codes
- Supporting clinical
|
For these members |
Fax your request to |
|---|---|
|
Commercial (HMO, PPO, Indemnity) |
1-866-577-9678 |
|
Federal Employee Program (FEP) |
1-888-282-1315 |
|
Medicare |
1-800-447-2994 |
Note: Please do not submit level of care change requests through Authorization Manager.
MPC_091224-1H-1-ART