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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. Finding the latest coronavirus (COVID-19) provider information Our provider communications about COVID-19 can be found here:
Some pre-COVID-19 utilization management requirements to resume July 1 With the end of the COVID-19 public health emergency, Blue Cross Blue Shield of Michigan and Blue Care Network will reinstate certain utilization management requirements that were in effect before the PHE. Read more: June 2023 issue of The Record Reminder: Prior authorization changes coming in June Michigan’s prior authorization law requirements go into effect on June 1, 2023. These requirements apply to health care insurers and providers in Michigan for members who have commercial coverage. Read more: Changes to maternity support program include new name, menopause support Last year, Blue Cross and BCN began working with Maven, an independent company, to provide a Family Building and Maternity Support Solution. We’ve renamed and enhanced it. Read more: June 2023 issue of The Record MAPS may not capture all information about a patient’s experience with controlled substances Health care providers using the Michigan Automated Prescription System should know that the database may not capture information about some controlled substances in a patient’s history. Read more: June 2023 issue of The Record Change Healthcare portal created to help providers import medical records Change Healthcare now offers eligible providers access to an online portal that allows the secure upload of requested medical records for the EquiClaim retrospective audits. EquiClaim is an independent company that provides auditing support for Blue Cross and BCN conducting medical claim audits for our members Read more: Blue Cross and BCN to use Audaire Health provider portal to capture clinical outcomes for CAR-T cell therapy drugs Starting July 1, 2023, Blue Cross and BCN will use the Audaire Health™ provider portal to track and capture clinical outcomes for CAR-T cell therapy drugs for Blue Cross commercial and BCN commercial members. Read more: June 2023 issue of The Record e-referral user guides updated We’ve recently updated the e-referral user guides with new sections:
Behavioral Health e-referral User Guide –
The user guides can be found on ereferrals.bcbsm.com under Training Tools. You’re invited to join PGIP as a physician organization We will be accepting applications from new physician organizations for the Physician Group Incentive Program from June 1 through July 31, 2023. To request application materials, send an email to valuepartnerships@bcbsm.com. Read more: June 2023 issue of The Record Reminder: Providers have a new email box to reach provider consultants Blue Cross and BCN want to make it easier and simpler for you to reach a provider consultant when you need to escalate a provider inquiry. To this end, providers in the East, Mid and Southeast regions now have a new email box to use: petcontactus@bcbsm.com. Read more: 2023 HEDIS® tip sheets available HEDIS tip sheets are developed to assist health care providers and their staff in efforts to improve overall health care quality and prevent or control diseases and chronic conditions. HEDIS is one of the most widely used performance improvement tools in the U.S. To access our tip sheets, follow these steps:
The 2023 HEDIS measures overview scenarios on-demand course is also available on the provider training website. Read more: May 2023 issue of The Record *Blue Cross Blue Shield of Michigan doesn’t own or control this website. Healthcare Effectiveness Data and Information Set; HEDIS® is a registered trademark of the National Committee for Quality Assurance. Holiday office closings Blue Cross and BCN offices will be closed June 19 (Juneteenth Day).
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Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. |