Do's and don'ts when submitting commercial SNF requests using the e-referral system

Starting Dec. 1, 2020, skilled nursing facilities were required to submit authorization requests for Blue Cross commercial and BCN commercial members through the e-referral system and not by fax.

You should fax the form only when the e-referral system is not available.

Here are important do's and don'ts when submitting your requests through the e-referral system:

  • On requests for initial admissions:
    • Do submit only one request for each member admitted. Don't submit a duplicate request while waiting to get the response.
    • Do include the admitting/attending physician in addition to the name of the facility.
  • On requests for additional days:
    • Do add an extension line so we know you're requesting the days. Follow the instructions in the e-referral User Guide (PDF) for "Extending an Inpatient Authorization."
    • Don't add more than one extension line.
  • On all requests:
    • Do complete the Skilled Nursing Facility Assessment Form (PDF) and attach it to the request in the e-referral system instead of faxing it.

      Note: Do include on the form the name and phone number of the person submitting the authorization request.

    • Do complete each field. Don't indicate "see attached" in lieu of completing the fields.
    • Don't request more than seven days.

Training resources for SNFs

It's important to use the available training resources to familiarize yourself with the e referral system, especially:

  • Checking member eligibility and benefits
  • Submitting an inpatient authorization request (requests for admissions and requests for additional SNF days)
  • Attaching a document to the authorization request

You can access a recorded webinar for SNFs and the webinar slides at ereferrals.bcbsm.com. Click Training Tools and scroll down to find the "e-referral Overview for Skilled Nursing Facilities presentation" - specifically:

Important next steps

If you haven't done so already, there are two important things you should do right away.