For Providers: Help Center

Find the answers you're looking for. Choose a topic to get started.

Provider online tools

Learn how to register for provider tools, add members to your account or edit access for existing members.

Learn about Health e-Blue, a way to track and share information about patient health.

Learn how to sign up for Electronic Data Interchange, or EDI, to exchange information like claims, electronic enrollment and patient eligibility.

With this application, group administrators can update their information with us and enroll new practitioners within their group.

Interested in the EFT and online vouchers program? Learn who is eligible and how to register.

Learn more about Risk Bearing Contracted Entity Medical Care Group Self-Service and how it can keep transactions secure and up-to-date.

Pharmacy services

We sometimes require providers to take additional steps before certain drugs are covered.

Learn what specialty drugs are, how to bill for them and what limitations we have on certain medications.

Learn more about our medical policies for our Medicare products to avoid a rejected claim.

Learn more about medical necessity and requesting coverage for a BCN Advantage member.

Enrollment

Find out what's involved in credentialing when you want to join our network and learn how to recredential when necessary.

National Provider Identifier, or NPI, is a provider's 10-digit unique identifier that represents them in HIPAA standard transactions. Learn more about why it's important.

Medicare Advantage

Learn your rights as a provider to appeal decisions about Medicare claims and payments.

If you've received a Medicare Advantage overpayment, learn how it will be corrected.

Follow these requirements to submit your claim correctly.

The Centers for Medicare & Medicaid Services issue star ratings for Medicare Advantage plans each year. Learn why this program matters to providers.

If you're serving our Medicare Advantage members, you must complete fraud, waste and abuse training. Learn how.

Learn which services require prior authorization for Medicare Advantage members.

Learn more about the services that are covered for providers who are non-contract or outside of Michigan.

Find information for providers who don't participate with Medicare or who are outside of Michigan.

Patient care management

Learn why we sometimes require medical chart reviews and how you can get reimbursed for them.

Learn more about Blue Cross Coordinated Care, a care management program designed to help qualified patients that have coverage with us.