Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

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Presentation transcript:

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. Blue Care Network Updates April 17, 2013

Referral Updates 2 Global referrals should be written for a minimum of 90 days For 3 chronic conditions – oncology, rheumatology, & renal management – global referrals should be written for one year Arthroscopy of the knee and lumbar spine surgery require clinical review effective March 1, Requests can be submitted on e-referrals; user will be prompted to complete a questionnaire

E-referral sign-up & change forms New forms are now available at ereferrals.bcbsm.com Old forms are no longer accepted All forms must be completed, printed, signed and then mailed or faxed to the BCBSM Electronic Business Interchange Group. Now that the e-referral ID is the same as the Provider Secured Service ID, reassigning an ID to a new employee or deactivating an ID can be handled at the same time New users can request access to e-referral at the same time as requesting access to Provider Secured Services New offices: Don’t forget sign the Use and Protection Agreement, along with the application. Current e-referral users can still add or delete practitioners from the user’s access This is the only time a unique form is needed for e-referral. 3

Blue Care Network Website 4

Group Contracting BCN now contracts at the group practice level for specialist providers As new specialists join a contracted group, once credentialed, they are considered participating in BCN networks under that group relationship and can begin to see BCN members. This occurs automatically from submission of the group change/enrollment form and no additional forms or paperwork is necessary. Reduces the number of contracts that have to signed or processed by individual physicians BCN networks have been deleted from the individual forms Submit a group change form to request a group contract 5

Web Denis Overview on BCN Billing Publications and Resources 6

We’d like to share valuable information about proper claim coding and documentation. A training webinar for professional billers and coders is available through web-DENIS and includes a QR code for accessing the webinar from a smart phone or tablet. To access the presentation, log in to web-DENIS and click on BCN Provider Publications and Resources, then click on Learning Opportunities. You can also access the training directly at brainshark.com/bcbsm/codinginitiative. 7

We Want Your Feedback! 8

Questions? 9