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May 2014

BCBSM making system changes for DME and P&O providers

Blue Cross Blue Shield of Michigan is making some changes to how we process claims for durable medical equipment and prosthetic and orthotic providers.

The claims processing system will soon be updated to reject claims for P&O services billed by DME providers, and DME services billed by P&O providers. Providers will be required to bill with the appropriate provider personal identification number, which aligns the services rendered with the PIN.

In previous issues of The Record, we let DME and P&O providers know we were recredentialing all providers in our DME and P&O provider network. We asked that all DME and P&O providers submit the certification letter that they received from the Centers for Medicare & Medicaid Services as well as a current copy of their site accreditation. For more details, refer to the March 2014 issue.

DME providers that bill for P&O services will be required to bill with a separate CMS accredited P&O PIN.

For more information, contact your provider consultant. You can also contact BCBSM’s Department of Provider Enrollment and Data Management at 1-800-822-2761, fax the department at 1-866-900-0250 or send an email to Providerenroll@bcbsm.com.

For claims-related inquiries, please continue to contact Provider Inquiry. Please review the Blue Pages directory of your online provider manual for telephone numbers and hours of operation.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2013 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
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