Elective Admissions

Primary care and specialist physicians are required to notify Blue Cross and Blue Shield of Nebraska (BCBSNE) at least 14 days before arranging elective inpatient, whenever possible.  

BCBSNE Care Management reviews the request to determine whether the setting is appropriate and, if required, meets criteria. Notification is made to the member, primary care physician, attending physician and facility of the determination.  

Facilities must provide clinical information to BCBSNE within one business day of the elective admission.  

Note: BCBSNE does not impose any administrative denials for failure to comply with the notification timeframes. Post service requests will be processed and decisions are based on medical necessity and the member’s benefit coverage only.