Oncology Services: Resources
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Shared resources
- Procedure codes for which providers must request prior authorization
— See this document to determine which procedure codes require prior authorization - Oncology: For cancer support, oncology drugs and radiation oncology — Includes information about care management and utilization management programs
Resources for services managed by OncoHealth
- Oncology Value Management program through OncoHealth: Frequently asked questions for providers
- Oncology Value Management program opt-out list for self-funded groups — See this document to determine which members have requirements under the program
Blue Cross resources
Resources for services managed by Carelon
- For URMBT non-Medicare members: Radiation oncology prior authorization list for UAW Retiree Medical Benefits Trust non-Medicare members — A list of radiation oncology procedures that require prior authorization through Carelon Medical Benefits Management for URMBT non-Medicare members. Includes modalities, grouper ID required codes and grouper names
- Frequently asked questions about Carelon: For cardiology, radiation oncology, radiology (high technology) and sleep studies (in lab)— Answers to questions about prior authorization requirements
Carelon Medical Benefits Management is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage prior authorizations for select services.
EviCore by Evernorth is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to manage prior authorizations for select services.
Frequently accessed documents
Additional resources
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