We’re making changes to Benefit Explainer

Starting Aug. 14, you’ll see updates we’ve made to Benefit Explainer. These changes are part of our effort to provide you with a more positive experience when your claims are processed. Below are some highlights.

The following changes will be made to the Benefit Package Report, under the BPR tab.

• We’re adding two subsections under Coverage Limitations:
• Benefit Limitations — This will display whether a member is responsible for payment.
• Provider Payment Limitations — This will display whether a provider is responsible for payment.
• The Concurrent Services header is being removed.
• The Member Liability header is being renamed Member Cost Share.
• Under the Additional Information header, we’re removing Optional Modifier and Additional Documents. (BCBSM Provider Manuals and Medical Policy will be under the Additional Information header.)

To view screen shots and get more in-depth information about Benefit Limitations and Provider Payment Limitations, click here.

The following changes will be made to the Medical/Payment Policy Report under the Medical/Payment Policy tab.

• We’re adding two subsections under Coverage Limitations:
• Medical — This will display medical policy.
• Provider Payment Limitations — This will display payment policy.
• Under the Additional Information header, we’re removing Optional Modifier and Additional Documents. (BCBSM Provider Manuals and Medical Policy will be under the Additional Information header.)

To view screen shots and get more in-depth information about Medical and Provider Payment Limitations, click here.

If you have any questions, contact your provider consultant.