Reminder: Blue Cross won’t pay for unused patient care items

In accordance with our participation agreements with providers, medical implants, devices or other equipment that aren’t used by a member for his or her treatment aren’t payable and shouldn’t be billed to Blue Cross Blue Shield of Michigan or to the patient.

This means that providers shouldn’t bill Blue Cross or our members for incorrectly ordered, manufactured, packaged or otherwise unusable implants, devices or equipment, including discarded and returned items. In addition, the cost of these unusable, discarded or returned items shouldn’t be included in any charges submitted or costs reported to Blue Cross.

This policy applies to all service sites, including, but not limited to, hospital inpatient and outpatient, ambulatory surgical facilities, physician offices and any other facility or professional setting where implants, devices or equipment are provided or implanted into patients.

Payments for any items that are charged to Blue Cross or the patient and are not used in the care of the patient will be recovered during any audits. We encourage you to work with your suppliers to ensure that all unusable items can be returned and are appropriately refunded.