Blue Cross to manage DME and P&O claims processing, customer service for auto group customers, URMBT members

Starting Jan. 1, 2014, Blue Cross Blue Shield of Michigan will begin managing benefits for our auto group customers and UAW Retiree Medical Benefits Trust members who use durable medical equipment and prosthetics and orthotics services.

Our current DME and P&O vendors will no longer handle claims processing and customer service for our General Motors, Chrysler, Ford and URMBT members. These vendors include DMEnsion Benefit Management and Northwood, Inc., which operate under the following program names:

• HME National Network
• SUPPORT
• Northwood National Provider Network

For the remainder of the year, auto group customers and URMBT members should continue using their current DME and P&O suppliers. Claims for services rendered before Jan. 1, 2014, should be submitted to the appropriate vendor.

Beginning Jan. 1, 2014, members will need to use suppliers who have a contract with their Blue Cross and Blue Shield plan. Participating DME and P&O providers that offer services to our auto group customers and URMBT members on or after Jan. 1, 2014, should bill the members’ local Blue plan. If a supplier ships medical supplies out-of-state to a member, then that supplier must participate with the Blue plan in the member’s state for the member to receive his or her full benefits. 
 
In addition, Michigan providers are reminded that accrued rental payments for DME items used under the member’s vendor program should be counted toward the Blue Cross-approved purchase price for those items. For more information, see the article on DME rentals in the October Record.

Keep in mind that Blue Cross will honor current prescriptions for rental DME and medical supplies as long as the supplier remains the same, the prescription is still valid and it covers the rental period for equipment or supplies being billed.

Starting in mid-November, members who receive life-sustaining equipment (such as oxygen tanks and dialysis equipment) from nonparticipating suppliers will get outreach assistance. A specialist in our Wellness and Engagement area may reach out to you to help members transition to a participating supplier.

This change does not apply to Blue Care Network, the State of Michigan and Michigan Public School Employee Retirement System, which will continue using the SUPPORT program and NNPN after Jan. 1, 2014.

Please contact your BCBSM provider consultant if you have any questions.