Blue Cross Blue Shield of Michigan Blue Care Network Lakeland Care Network Payor Conference October 19, 2016 Katie Rogers and Kathy Fletcher Provider Relations Consultants Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Resources / Tools WebDenis / Benefit Explainer http://www.bcbsm.com/providers/help/faqs/sign-into-secured-services.html Eligibility Benefits Deductible / Co-pay information Claim status PARS (Provider Automated Response System) Monday through Saturday, 7 a.m. to midnight. Sunday: 7 a.m. to 8 p.m. Hospitals and facilities 1-800-249-5103 Federal Employee Program 1-800-840-4505 MDs, DOs, DPMs, PhDs, Chiropractors, DME, suppliers and labs 1-800-344-8525 Vision and hearing 1-800-482-4047 questions or feedback on PARS - pibs@bcbsm.com Provider Enrollment and Change Self Service http://www.bcbsm.com/providers/help/faqs/enrollment-faqs.html Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Enrollment / Credentialing Helpful tips: Keep Council for Affordable Quality Healthcare® ProView ® information current, and complete your re-attestation every 120 days. Update “Authorize” section on CAQH. Maintain current board specialty and certification status on CAQH. Designate your primary specialty on CAQH with care and consideration. Provide CAQH with a current malpractice insurance face sheet. Require your malpractice carrier to submit your liability insurance information in a timely manner. If practicing exclusively in an inpatient hospital setting, be sure to update CAQH accordingly. New graduates should wait until 60 days prior to completing training before submitting their application. Practitioners relocating from out of state can submit their application 30 days prior to their start date. Be sure to sign and include all required signature documents Requesting a status: Practitioners currently being credentialed or recredentialed may request the status of their application by contacting the Provider Enrollment and Data Management department. Have the following items ready: National Provider Identifier Tax ID/Social Security number Primary address and phone number Provider Enrollment and Data Management (PEDM) CAQH help desk 1-800-822-2761/fax 1-866-900-0250 1-888-599-1771 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
BCBSM Provider Publications and Resources Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
BCN Provider Publications and Resources Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Provider Manuals Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Provider Manuals Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Standard ID Cards See BCBSM and BCN specific ID Card Brochures for more detailed information. Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Prior Authorization Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Prior Authorization, cont… Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
E-referral www.ereferrals.bcbsm.com Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Who to call Provider Inquiry BCBSM Professional 1-800-255-1878 BCBSM Facility 1-800-643-2583 Federal Employee Program 1-800-482-3600 BCBSM Medicare Advantage 1-866-309-1719 BCN and BCNA 1-800-255-1690 EDI – front end rejection on claim 1-800-542-0945 BlueCard (BCBSM and MA) 1-800-676-BLUE (2583) WebDenis / Provider Secured Services 1-877-258-3932 If you have contacted the above areas without resolution, the Provider Relations department will be more than happy to assist. Please provide the name of the person/department you spoke with so we don’t duplicate efforts. BCBSM Professional Claim Specialist: Sarah Pike at 616-389-2119 or spike@bcbsm.com BCBSM Facility Claim Specialist: Jeff Munn at 616-389-2116 or jmunn@bcbsm.com BCN/BCNA Specialist: Jennifer Gallandt at 616-389-2136 or jgallandt@bcbsm.com BCBSM/BCN Professional Provider Consultant BCBSM/BCN Facility Provider Consultant Katie Rogers Kathy Fletcher krogers2@bcbsm.com kfletcher@bcbsm.com Ph: 269-321-7677 Ph: 616-389-2049 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.
Questions? Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.