BlueCard^® connection: Are Blue Cross providers contracted to treat members of other Blue plans?

As a Blue Cross Blue Shield of Michigan participating health care provider, you’re contracted for services you bill through Blue Cross for members enrolled in other Blue plans.

Blue Cross’ contracted services and policies include:

• Timely filing
• Claims reporting
• Reimbursement
• Not balance-billing a patient for an amount more than Blue Cross Blue Shield of Michigan allows for a service covered under the patient’s home plan

For Tennessee Medicaid members whose plan prefix is ZEC, all providers are required by the State of Tennessee to register with TennCare. Unregistered providers won’t be reimbursed for services reported for TennCare patients.

If you need assistance with a claim for a patient enrolled in another Blue plan, including Medicare crossover, ancillary claims or air ambulance claims, contact our Provider Inquiry department. The representative in Michigan can assist you and will work with the patient’s home plan on your behalf when necessary.

For more information on the BlueCard program, including links and articles on online tools, reference the BlueCard chapter of the online provider manuals.

If you’re experiencing issues with the information provided in the BlueCard chapter of the online manual — or if you’d like more information on a particular topic — contact your provider consultant.

Want to suggest a topic to be covered in this series? Send an email to ProvComm@bcbsm.com and put “BlueCard series” in the subject line.