Training tips and opportunities: Resources to help make your job easier

This is the first article in a series designed to make you aware of the training resources available to health care providers and how to access them. This month we’ll take a close look at the Blue Cross Blue Shield of Michigan provider manuals.

We publish a customized manual for each provider type. The manuals cover a wide variety of topics. Some chapters focus on a particular  type of service — for example, chiropractic services or hospice services — and explain the benefit, as well as related medical policies and payment policies.

The ”Durable Medical Equipment, Medical Supplies, and Prosthetics and Orthotics Services” chapter and the “Physical Therapy, Occupational Therapy, and Speech Therapy Services” chapter are other examples. These “services” chapters also contain billing guidelines specific to their service type.

Other chapters aren’t specific to benefits and types of service but rather explain processes you need to understand in order to do business with us. For example, you need to know how to determine patient eligibility, patient copayments and deductibles; which services and procedures require preapproval and how to request it; how to complete and submit claims, and how to resolve any problems you may encounter; which documentation facts are needed in your patient medical records.

At the end of each chapter you’ll find a section named “Related newsletter articles,” which contains links to articles that have been published in The Record on that chapter’s topic. The chapters are customized to your provider type and clearly named so you can make the correct selection when you’re looking for information.

Each manual begins with a chapter named “Blue Pages Directory,” which contains an alphabetic listing of BCBSM contact information — phone numbers, fax numbers, email and mailing addresses for various departments and agencies affiliated with BCBSM.

To access the BCBSM provider manuals, follow these steps:

• Log in to web-DENIS.
• Click on BCBSM Provider Publications and Resources.
• Click on Provider Manual.
• Click on Provider Type.
• In the Provider Type Criteria box, click the down arrow next to Make Selection, and select your provider type.
• Click on Search.

If you do not have a user ID and password for web-DENIS:

• Visit bcbsm.com.
• Click on Provider.
• Click on Provider Secured Services and follow the instructions.

Use the Blues provider manuals flier to find any of the Blues provider manuals, including:

• The BCBSM provider manuals described earlier in this article
• The BCBSM Medicare Plus BlueSM PPO Manual
• The BCN Provider Manual
• The Blue Cross Complete Provider Manual

The flier is posted on web-DENIS:

• From the homepage of web-DENIS, click on BCBSM Provider Publications and Resources.
• Click on Newsletters and Resources.
• Go to the “What’s New” section of the page. Or click on Provider Training on the left, and then scroll down to the “Job aids, FAQs, brochures and fliers” section of the page. Click on BCBSM and BCN provider manuals: How to find and how to use them.