BCBSM/BCN Dual Header The Record Header Logo

The Record - Insurance Card with the BCBSM/BCN Cross and Shield logo that reads, Blue Cross Blue Shield, Blue Care Network of Michigan. Tagline: Confidence comes with every card. Image of Note boards with paper that has the letters RX on it accompanied by a stethoscope

Forward to a friend  |  Subscribe  |  The Record Archive  |  Contacts  |  bcbsm.com  |  Print this article
August 2017

Physician assistants must re-enroll with Blue Cross, BCN starting October 2017

Physician assistants must re-enroll to be reimbursed for services within their scope of license for dates of service on or after Feb. 1, 2018. Beginning Oct. 1, 2017, physician assistants must:

  • Re-enroll and be credentialed with Blue Cross Blue Shield of Michigan and Blue Care Network, including our Medicare Advantage programs.
  • Complete our attestation form, indicating that they have a legally required practice agreement with a physician, along with other required documents.
  • For participation with BCN, enroll as part of an existing contracted group or request participation via a new group practice.
  • Complete a CAQH ProView credentialing application within 14 calendar days of submitting enrollment requests.

Current reimbursement arrangements will be terminated for dates of service after Jan. 31, 2018.

Regarding dates of service on or after Feb. 1:

  • PAs who have re-enrolled by Jan. 31 will be eligible for reimbursement for services within their scope of license either directly or under a group for all lines of business. PAs who have not will have their claims denied.
  • PAs may choose to continue to be affiliated with physician groups and bill under the groups. If so, PAs should ensure they indicate the groups’ information when they contract and re-enroll.
  • PAs will continue to be reimbursed at 85 percent of the physician fee schedule.
  • Current BCN authorization and referral requirements will continue to apply.

Why are Blue Cross and BCN making this change?

We’re making this change because the state of Michigan allows PAs to work within their full scope of practice without direct or general supervision by a participating physician. The state also requires that PAs initiate and maintain a practice agreement with participating physicians.

How to contract and re-enroll

Starting Oct. 1, PAs can find and use the Blue Cross and BCN practitioner agreements and enrollment forms on bcbsm.com.

We’ll also provide additional information in upcoming editions of The Record and BCN Provider News.

If you have questions, contact Provider Inquiry or your provider consultant.

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.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.