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Resources - cardiology, radiology and in-lab sleep studies Requests should be submitted before the services are provided.

By logging in directly to the Carelon ProviderPortal ®*.

Click the Carelon ProviderPortal tile on the Applications tab.

Click Payer Spaces on the menu bar and then click the BCBSM and BCN logo.

You can access the Carelon ProviderPortal:

For Medicare Advantage members, submit requests using any of the methods below.

Alternate submission methods (phone) are allowed in the case of temporary technological problems, such as power or internet outages.

For commercial members, Michigan’s prior authorization law* requires health care providers to submit prior authorization requests electronically.

Submit authorization requests to Carelon as follows:

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How to submit prior authorization requests When these services are performed in an observation, emergency or inpatient care setting, they don't require authorization. Prior authorization requirements apply to services performed in the following settings: These requirements don’t apply to the UAW Retiree Health Care Trust (group number 70605) or the UAW International Union (group number 71714).įor more information, see the Summary of utilization management programs for Michigan providers (PDF).For Blue Cross commercial members, see the Carelon exclusion list for Blue Cross Blue Shield of Michigan Commercial (PDF) to learn about the health plan, groups, and settings and scenarios for which prior authorization isn't required.Radiation oncology - UAW Retiree Medical Benefits Trust non-Medicare members.To determine which groups have opted in and the date on which they opted in, see the Carelon medical oncology prior authorization program opt-in list for Blue Cross commercial self-funded groups (PDF). Select Blue Cross commercial self-funded groups, including UAW Retiree Medical Benefits Trust.Blue Cross commercial fully insured members, including MESSA members.Medical oncology - This applies to the following:.High-tech radiology - This includes procedures for Michigan Blue Cross and Blue Shield Federal Employee Program ® members.

This includes cardiac implantable devices and services.

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Cardiology services - Medicare Plus Blue SM.

Providers must obtain authorization from Carelon Medical Benefits Management (formerly AIM Specialty Health ®) for the following services: Personally visits the Medanta for returning the Device.Carelon-Managed Procedures (formerly AIM) Refund of DepositĪmount shall be made through the same mode of payment as that of purchase in cases where the User The refund of DepositĪmount shall be subject to return of the Device in working and undamaged condition. In cases where the User has opted for availing the Services through rented Device, a refundable depositĪmount of ₹ 5,000 (“ Deposit Amount”) shall be applicable and paid by the User. The extended program availed by the User shall be activated automatically on expiry of existing program of services. For the said purposes, the User can call our helpline number +414 or visit Provided that the Device has not been unboxed.īefore the expiry of service duration, the User can extend the services by availing various program

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Service on the day of purchase in which case, full amount of service fees shall be refunded to the User

The services once availed cannot be cancelled except in cases where the User requests to cancel the Neither does Medanta endorse or promote the Device in any manner nor will Medanta be liableįor any claims, representations or warranties, whether express or implied as to the safety, reliability,ĭurability and performance of the device. Of services by Medanta is being provided on “as is” and “as available” basis through Alivecor India Private The User hereby agrees and acknowledges that the Device (hardware and software) used in the provision

The User agrees and acknowledges that the User has read, understood and accepts the terms and conditions contained in the brochure provided with the Device (“ Device”) with respect to its usage, operations, return / replacement and warranty policy.