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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.
New rider for large groups in the Upper Peninsula will limit coverage outside Michigan Effective Oct. 1, Blue Care Network large group plans will require a mandatory rider for group customers with locations in the Upper Peninsula. The rider will limit coverage outside Michigan to urgent, emergency or accidental services. 2022 ICD-10 CM and PCS code updates available Fiscal year 2022 ICD-10-CM** and ICD-10-PCS** code updates, effective with dates of service on and after Oct. 1, 2021, are available on the Centers for Medicare & Medicaid Services website. This year’s updates include 350 new CM and PCS (diagnosis and inpatient procedure) codes, 83 CM and PCS code revisions and 139 CM and PCS deletions. **Blue Cross Blue Shield of Michigan doesn’t own or control this website. CareCentrix to manage network for independent home infusion therapy and ambulatory infusion suite providers, starting Jan. 1 Effective Jan. 1, 2022, Blue Cross Blue Shield of Michigan and Blue Care Network will delegate management of the in-state independent home infusion therapy and ambulatory infusion suite provider network to CareCentrix® for commercial members. Contact Provider Inquiry for claims issues If you’re experiencing claims or complex claims issues, contact Provider Inquiry. If you call your provider consultant, you’ll first need a reference number from Provider Inquiry.
Holiday office closings Blue Cross and BCN offices will be closed on Sept. 6 for Labor Day. Providers may only bill members for applicable deductibles and copayments We want to reminder providers that you must bill Blue Cross and BCN for all covered services and may only bill members for applicable deductibles and copayments. In keeping with provider contracts, you may not collect deposits or bill members upfront for unpaid balances of covered services. September is Suicide Prevention Awareness Month Blue Cross is committed to helping its members cope with mental health issues as part of their overall health. That’s why we recently developed a Behavioral Health Campaign for members, including member emails, a behavioral and mental health website, advertising and more. We’re transitioning to a new pharmacy benefit manager We’re moving from Express Scripts, Inc. to OptumRx on Jan. 1, 2022, for commercial individual and group members, and Jan. 1, 2023, for Medicare Advantage individual and group members. The change is expected to improve the pharmacy experience for members and customers, better manage drug costs and drive better health outcomes. Training updates New eLearning lesson about evaluation and management guidelines is available on provider training website Lunch and learn webinars for physicians and coders focus on risk adjustment, coding New eLearning training videos to focus on Medicare Star Ratings Reminder: on-demand training available | |
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. |