Acute Inpatient Medical and Surgical Admissions: Resources

• Procedure codes for which providers must request prior authorization
• Submitting acute inpatient authorization requests: Frequently asked questions for providers
• Holiday closures: How to submit authorization requests for inpatient admissions
• How to request a peer-to-peer review with a Blue Cross or BCN medical director
• Acute inpatient admissions: For prior authorization determinations — Includes information about our utilization management program

Forms

• Acute inpatient hospital assessment form
• Physician peer-to-peer request form (for non-behavioral health cases)

Medicare Advantage Resources

• See the FFS & MA IM/DND webpage on the cms.gov website to access the following:
• Important Message from Medicare
• Detailed Notice of Discharge
• For patients in observation:
• CMS Beneficiary Notices Initiative — Scroll down and click to open the Medicare Outpatient Observation Notice (MOON)
• MOON form instructions