Who is responsible for notifying BCN when I seek services out of network if a service requires a prior authorization?
You must have a BCN authorization for certain services before you get care from providers who aren’t part of BCN’s network. You are responsible for getting this authorization by calling 1-800-392-2512. However, providers can contact BCN on your behalf. If you receive medical care from providers who aren’t part of the BCN network, without BCN authorization as required for specific services, you’ll be responsible for the cost of the service. Inpatient care, physical therapy and gastric bypass surgery also require authorization. Note: If a member has previously received authorization for a service from a different health plan they were previously enrolled in (such as PHP or Community Blue), that authorization does not automatically transfer to BCN. The BCN contracted provider or the member must seek a new authorization from BCN.
