Name of Manual - Blue Cross and Blue Shield of Minnesota

Blue Plus
Referral Points Remember these important points about referrals:
• PCCs must have an established referral process.
• PCCs must notify Blue Plus of authorized referrals via our
provider web self-service product at www.providerhub.com.
• The member may receive services only from the clinic named
in the referral or standing referral.
• The referral provider or specialist may not refer members to
other providers without written consent from the PCC. If no
referral is given, members will be responsible for any reduced
benefits. Exceptions are made for Minnesota Health Care
Program Members.
• In some cases, we will request a second referral if information
from the referred provider’s claim does not match information
received on the initial referral.
• If a member who has a referral or standing referral changes
PCCs, the referral or standing referral will no longer be valid
as of the date of the PCC change. The member’s new PCC
must now coordinate their member’s care.
6-12 Blue Cross Blue Shield of Minnesota Provider Policy and Procedure Manual (12/27/10)