1. 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.

2. Resources / Tools WebDenis / Benefit Explainer
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
Federal Employee Program
MDs, DOs, DPMs, PhDs, Chiropractors, DME, suppliers and labs
Vision and hearing
questions or feedback on PARS -
Provider Enrollment and Change Self Service
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

3. 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
/fax
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

4. 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. 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.

10. 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.

11. 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.

12. Who to call Provider Inquiry BCBSM Professional 1-800-255-1878
BCBSM Facility
Federal Employee Program
BCBSM Medicare Advantage
BCN and BCNA
EDI – front end rejection on claim
BlueCard (BCBSM and MA) BLUE (2583)
WebDenis / Provider Secured Services   
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 or
BCBSM Facility Claim Specialist: Jeff Munn at or
BCN/BCNA Specialist: Jennifer Gallandt at or
BCBSM/BCN Professional Provider Consultant BCBSM/BCN Facility Provider Consultant
Katie Rogers Kathy Fletcher
Ph: Ph:
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

13. 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.