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This newsletter includes short summaries, reminders and updates for Blue Cross and BCN providers. Please visit The Record or BCN Provider News for complete newsletter editions.
Thank you to our providers We thank you for your work on the front lines of the COVID‑19 pandemic — for saving the lives of our members and improving our community. You’re our heroes and we’re proud to partner with you. A roundup of recent news about the COVID-19 pandemic Blue Cross Blue Shield of Michigan and Blue Care Network have made many changes to support health care providers and protect members during the COVID-19 public health crisis. Read about our efforts on facilitating testing and treatment, expanding telehealth services, reducing utilization management requirements, ensuring patients have access to the medications they need and extending many deadlines to support you and our members on Page 1 of the July–August 2020 BCN Provider News or the June 2020 issue of The Record. Blue Cross teams up with Michigan hospitals for COVID-19 data collection efforts Blue Cross is working with 35 Michigan hospitals to coordinate clinical data on COVID‑19 patients into a comprehensive registry. The registry, called MI-COVID19, will provide new insights into best practices in treating patients with the virus, and will likely be one of the largest collections of COVID‑19 patient data to date. For more information, see the May–June 2020 Hospital and Physician Update. Outpatient psychiatric centers can submit telemedicine claims to Blue Cross using their OPC NPIs Blue Cross’ commercial PPO can now accept telemedicine claims from outpatient psychiatric centers using the OPC facility NPI. This change was effective in April and brings the PPO commercial billing guidelines in line with those of BCN. OPC providers no longer need to submit claims for telemedicine services using their individual professional NPI or bill under the NPI of a supervising physician for Blue Cross commercial PPO claims. For more billing details, see the June 2020 issue of The Record. BCN increases its skilled nursing facility reimbursement rates Blue Care Network is increasing its fees for skilled nursing facilities reimbursed at BCN SNF fee schedule rates. This applies to:
For more information, see Page 9 of the July–August 2020 BCN Provider News. Holiday office closings Blue Cross and BCN offices will be closed July 3 (Independence Day). We’re revising our Participating Hospital Agreement Blue Cross Blue Shield of Michigan is in the process of updating its model Participating Hospital Agreement. Due to current events, this course of action could be subject to change. The new PHA model will modernize contractual language, define processes and augment future efforts to address affordability issues. To learn more about the PHA changes, see the June 2020 issue of The Record. Webinar recordings now available for 2020 sessions Provider Experience is continuing to offer training resources to help clinical and administrative staffs work more efficiently with Blue Cross and BCN. You can now access recordings of provider training webinars delivered so far in 2020 through web-DENIS. For more information, see the Page 9 of the July–August 2020 BCN Provider News or the June 2020 issue of The Record. We’re issuing new alphanumeric contract numbers in 2021 Blue Cross and BCN will issue alphanumeric contract numbers to new members starting sometime in 2021. This is a change from the previously announced start date, which was July 1, 2020. Additional information will be published once the exact implementation date is identified. For more information, see Page 7 of the July–August 2020 BCN Provider News or the June 2020 issue of The Record. Reminder: Submit authorization requests for all surgical procedures related to musculoskeletal conditions to TurningPoint As a reminder, you’ll need to submit authorization requests for all surgical procedures related to musculoskeletal conditions to TurningPoint Healthcare Solutions LLC. This is effective for procedures scheduled on or after July 1 for BCN HMOSM (commercial), BCN AdvantageSM and Medicare Plus BlueSM PPO members. As of June 1, authorization requests are now being submitted to TurningPoint.
For more details or to register for a training webinar, see Page 37 of the July–August 2020 BCN Provider News or the May 2020 issue of The Record. State of Michigan retirees join our Medicare Advantage PPO plan State of Michigan retirees became members of our Medicare Plus BlueSM plan, effective Jan. 1, 2020. Their plan, called State Health Plan MA, provides coverage for medical and surgical benefits (Part C). OPTUMRx® administers their prescription drug benefits (Part D). State Health Plan MA members have some additional enhanced benefits not offered to other groups. To find these benefits, visit bcbsm.com/providers, then click Medicare Advantage, Toolkits, Get Medicare Advantage Provider Toolkit, Enhanced Benefits (under the Coverage Details category), then the Active dropdown menu. For more information, see the April 2020 issue of The Record. | |
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. |