Blues Brief

Download a printable version to read or shareMay 2022

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.

Transition to Availity

Notice: Last day for Provider Secured Services and web-DENIS is June 21

Blue Cross Blue Shield of Michigan and Blue Care Network’s Provider Secured Services and web-DENIS will have their last day of operation on June 21. Beginning June 22, these tools will no longer be available.

Blue Cross Commercial Provider Manual has moved to our new provider portal

The Blue Cross Commercial Provider Manual has moved from Benefit Explainer to our new provider portal, Availity℠.

Designate Availity administrator and ensure access to e-referral and Health e-Blue within Availity

Your Availity^® administrator needs to take action to set up access to e-referral and (if appropriate) Health e-Blue℠. This will ensure users can access these tools through Availity Essentials.

New Secure Provider Resources site

Information you used to find on either the BCBSM Newsletters and Resources or the BCN Provider Publications and Resources sections of web-DENIS are now combined into a single location, the Secure Provider Resources website.

SecureCare^® to manage certain services

Blue Cross Blue Shield of Michigan has contracted with SecureCare^®, an independent network performance management company, to manage outpatient PT, OT, ST, physical medicine and chiropractic services for Blue Cross commercial and Medicare Plus Blue℠ members starting July 5.

Outpatient PT, OT services no longer require prior authorization for Medicare Plus Blue℠ members

Medicare Plus Blue will no longer require prior authorization for outpatient physical and occupational therapy services for dates of service on or after April 1. You can submit retroactive authorization requests to eviCore through July 29 for dates of service prior to April 1.

Providers in East, Mid and Southeast regions 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.

Holiday office closings

Blue Cross and BCN offices will be closed May 30 (Memorial Day).

Outpatient PT, OT and ST, and physical medicine services by chiropractors and athletic trainers document updated April 2022

The Outpatient PT, OT and ST, and physical medicine services by chiropractors and athletic trainers document has recently been updated. This document provides a brief overview of the utilization management services provided by eviCore healthcare^®. The PDF can be found on the BCN Outpatient PT, OT, ST and Blue Cross Authorization Requirements & Criteria pages of ereferrals.bcbsm.com.

How to confirm the networks with which you participate

We have a document that helps providers find the Blue Cross and BCN products with which they participate. Finding your plans and networks shows you how to use the online provider search to confirm which products you accept.

Here's how to find the document:

Log in to our provider portal (availity.com).
Click Payer Spaces on the Availity menu bar.
Click the BCBSM and BCN logo.
Click Secure Provider Resources (Blue Cross and BCN) on the Resources tab.
Choose a product from the Products drop-down menu. The PDF will be at the top of the page.

Blue Cross changing practitioner fees July 1

Blue Cross will change practitioner fees for services with dates of service on or after July 1. This change applies to services provided to our Traditional, TRUST and Blue Preferred Plus℠ members, regardless of the customer group. Fee schedules effective July 1 are available on web-DENIS and Availity.

We’re making changes to our practice profiles and providing TRUST PPO network information updates

When you receive a practice profile from Blue Cross Blue Shield of Michigan, you may notice it’s in a new format. We’re using a different application to pull the reports, which has resulted in some changes.

Blue Cross provides physical therapy benefits for GM hourly employees under group number 83200

Effective Jan. 1, 2022, Blue Cross will administer outpatient physical therapy benefits to GM hourly populations under group number 83200. TheraMatrix will no longer be the outpatient physical therapy provider for this group.

Finding the latest coronavirus (COVID-19) provider information

Our provider communications about COVID-19 can be found here:

Coronavirus (COVID-19) information updates for providers webpage located within BCBSM Newsletters and Resources or BCN Provider Publications and Resources on web-DENIS (until June 21)
In the Member Care section of our secure Provider Resources site, accessible through Availity
Our public webpage for providers is located at bcbsm.com/coronavirus. Click on For providers.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.