Updated questionnaires available in the e-referral system on Dec. 20

We use our authorization criteria, our medical policies and your answers to the questionnaires in the e-referral system when making utilization management determinations on your authorization requests.

Starting Dec. 20, 2020, updated questionnaires will open in the e-referral system for certain procedures. In addition, updated preview questionnaires, which show the questions you'll need to answer in the actual questionnaires, will be available on this website.

Questionnaire updates

We're updating the following questionnaires:

• Biofeedback (non-behavioral health) for BCN commercial members
• Biofeedback (non-behavioral health) for BCN Advantage members

For both questionnaires:

• You'll need to complete them for procedure codes *90901 and *90912.
• You'll no longer need to complete them for procedure code *90911.

Preview questionnaires

You can access preview questionnaires on this website. This can help you prepare your answers ahead of time.

To find the preview questionnaires, click BCN and then click Authorization Requirements & Criteria. Scroll down and look under the "Authorization criteria and preview questionnaires" heading.

Authorization criteria and medical policies

The pertinent authorization criteria and medical policies are also available on the Authorization Requirements & Criteria page.

*CPT codes, descriptions and two-digit modifiers only are copyright 2019 American Medical Association. All rights reserved.

Posted: December 2020
Line of business: Blue Care Network