We’ve made changes to Ambulance Provider Participation Agreement

A new ground and air Ambulance Provider Participation Agreement — a combined Blue Cross Blue Shield of Michigan and Blue Care Network agreement — has been approved by the Michigan Department of Insurance and Financial Services.

It includes changes to the existing Medical Necessity Criteria and Confidentiality Policy. To view the agreement, which has been posted on bcbsm.com, click here.

Enrollment materials will be available electronically from bcbsm.com/providers by June 1, 2017. Follow these steps to enroll:

Visit the Enrollment and Changes section.
Click on Provider Enrollment Form.
Select Physicians and Professional.
Select Enroll a New Provider.
Under “Allied Providers,” select Ambulance.
Select BCBSM agreements and signature documents.
Select BCBSM Ambulance Provider Participation Agreement.

Effective dates

For newly enrolled providers, the agreement will be effective immediately upon enrollment.
For providers who signed a Letter of Agreement prior to the Michigan Department of Insurance and Financial Services granting their approval, the effective date was Jan. 1, 2017.
For providers who agreed to the terms of the previous Ambulance Provider Participation Agreement, the effective date is Sept. 1, 2017.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2016 American Medical Association. All rights reserved.