New Master Medical reimbursement process
We've simplified the Master Medical reimbursement process as part of our initiative to modernize and consolidate our computer systems. Participating providers will deal directly with BCBSM for payment, relieving doctors and members of the extra steps often needed to settle patient accounts.
- BCBSM now reimburses participating providers directly for covered Master Medical services (except prescription drugs), instead of sending payments to the subscriber.
- You will no longer have to submit claims to BCBSM or make payments to participating providers, except for your normal deductibles, coinsurance and/or copayments.
- Master Medical benefits, including coverage limitations and exclusions, remain the same.
- If your prescription drugs are covered through your Master Medical coverage, we will continue to send payment for approved drugs to you after the transfer.
- You must pay for your prescription drugs at the pharmacy as you do today.
- To request reimbursement, you must submit the Member Application for Payment form (PDF) along with itemized receipts to BCBSM.
Receiving care from nonparticipating providers
If you choose care from a nonparticipating provider, you may be asked to pay for covered services upfront.
- To request reimbursement for paid services to a nonparticipating provider you must submit the Member Application for Payment form (PDF) with itemized receipts.
- We will send payment directly to the subscriber.
- Payment will equal our approved amount for the covered service less any deductible, coinsurance and/or copayments.
- Any remaining balance will be your responsibility.
How to submit a Master Medical claim received from a nonparticipating provider
Learn everything you need to know to submit a Master Medical claim if your Blue Cross Blue Shield of Michigan coverage has been transferred to the new system.
Master Medical claim checklist
Use the checklist to help gather all your information.
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