‘Provider consent to change’ option no longer available when calling Provider Inquiry

With the automation of both professional and facility replacement and void/cancel claims, we have removed the “provider consent to change” option from Provider Inquiry. If you have changes to a previously reported claim, report them on a claim form using the appropriate frequency codes: 7 for a replacement claim; 8 to void or cancel a claim.

Refer to the October Record for additional information on the appropriate reporting of replacement and void/cancel claims.

Provider Inquiry will continue to help you initiate an adjustment if you reported a valid and accurate claim but the claim did not process as expected. Examples include:

• Facility dual diagnosis claims (screening versus diagnostic) when only the screening or diagnostic service was processed
• Claims affected by a Blue Cross Blue Shield of Michigan system or processing issue

You may continue to receive calls from Customer Service on dual diagnosis facility claims or on a professional claim when we require additional information from you. We’re committed to resolving claim inquiries received from both providers and members on the first call if possible. If you can provide the information requested during the call — and a claim adjustment is appropriate — we’ll initiate it immediately on your behalf.

For more information on claim reporting, including links and articles to claim examples, reference the Claims chapter of the online provider manuals.