Reminder: Update your Provider Authorization form when changes occur

Blue Cross Blue Shield of Michigan is dedicated to safeguarding the protected health information of our members. These safeguards include completion of a Trading Partner Agreement and Provider Authorization form as part of the setup process for the electronic data interchange. All EDI trading partners must complete a TPA and Provider Authorization form before they can exchange PHI with Blue Cross.

Terms of the TPA require you to notify Blue Cross of any changes in your trading partner information. If you switch service bureaus (clearinghouses), software vendors, billing services or the recipient for your 835 files, you must update your Provider Authorization form. Updating the form ensures information is routed to the appropriate destination. You don’t need to update the Provider Authorization form if your submitter and trading partner IDs don’t change.

Keep these items in mind when changes occur. You should review the information on your Provider Authorization form if you’ve:

• Joined a new group practice
• Left a group practice and now bill using your own national provider identifier
• Hired a new billing service
• Started submitting claims through a clearinghouse or you’ve changed clearinghouses
• Decided you no longer want to receive 835 remittance files
• Selected a new destination for your 835 files

You must update your Provider Authorization form if you’ll send claims using a different submitter ID or route your 835 files to a different unique receiver or trading partner ID.

To make changes to your EDI setup, visit bcbsm.com/providers and follow these steps:

• Scroll down, and click on Quick Links on the right side of the page.
• Click on Electronic Connectivity (EDI).
• Scroll down to the EDI agreements section, and click on Update your Provider Authorization Form.

If you have questions about EDI enrollment, contact our Help Desk at 1-800-542-0945. For assistance with the TPA and Provider Authorization forms, select the TPA option.