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October 2014
BlueCard® program offers plenty of support options for provider community
 Members of several different teams — including Provider Inquiry, Provider Enrollment and Data Management, Claims and Blue Card System Support, and BlueCard Host Program Support — work together to support the BlueCard program. Back row, from left: Erica Jones, Paul Ozdarski, Susan Lawrence, Rodney Ross, Paul Nettles, Kisha Horton and John Murnik. Front row, from left: Lisa Washington, Melanie Floyd and Therese Kushnir.
This is part of a series designed to improve your experience with the BlueCard program.
In previous editions of The Record, we’ve provided you with overviews of the BlueCard program and the online tools that can help you provide services to BlueCard members. This month we’d like to make sure you’re aware of the support system at Blue Cross Blue Shield of Michigan that helps our providers in the BlueCard Host program:
- BlueCard provider advocates assist provider consultants in educating the provider community about the program. They also work on projects to improve BlueCard processes, resolve issues and support our provider community at corporate and national workgroup meetings.
- Provider Inquiry representatives handle phone calls and written inquiries about professional and facility claims submitted to ITS BlueCard Host. The department uses many resources to help you resolve claim issues. And you can also call Provider Inquiry to hear automated messages that include important information from the BCBSM BlueCard department.
- Provider Enrollment is responsible for collecting and updating your billing department’s contact fax number and address. We use that information to send you any medical record requests we receive from other Blue plans for claims you’ve submitted to us. Providing us with your billing department’s fax number allows us to forward responses to you quickly and accurately. If you haven’t already responded to our outreach, please contact Provider Enrollment at 1-800-822-2761.
- BlueCard Host claims processers are dedicated to processing thousands of BlueCard professional and facility claims received from Michigan providers. The team also works directly with other Blue plans to resolve claim inquiries and process BlueCard claim adjustments.
- Claims and BlueCard System Support provides assistance to the BlueCard Host claims department with complex claims analysis. The department serves as a liaison between the Information Technology department and the Claims Operations team. It focuses on improving member and provider experiences by performing root cause analysis on problematic claims and implementing improvements.
- ITS Host Program Support is responsible for the system processing and quality of BlueCard Host claims. The department supports small system enhancements, projects, mandates, BlueCard plan program audits and production support to ensure that Inter-Plan Programs policies are met.
- There is a BlueCard executive at every Blue plan in the Blue Cross® and Blue Shield® Association. Kim Jones-Schneider, the director of our BlueCard Operations and Service department, is also our BlueCard executive. Jones-Schneider represents BCBSM on projects, and she works with other Blue plans and the Association to ensure that our providers’ and member’s interests are met. BCBSM takes a leading role on many Blue projects and the implementation of Association mandates.
Do you have any suggestions or comments regarding BlueCard? If so, please contact your provider consultant to provide us with feedback. We welcome your input as we work to improve your BlueCard experience. |
