Remember to refer Blue Cross members to network providers

Providers affiliated with Blue Cross Blue Shield of Michigan and Blue Care Network have a contractual obligation to use network providers when referring our members for services. This includes referring members for toxicology and drug-of-abuse testing services, and applies to both Blue Cross and BCN commercial and Medicare Advantage members enrolled in the following plans:

• Blue Cross PPO
• Blue Cross Medicare Plus Blue^SM PPO
• BCN HMO^SM
• BCN Advantage^SM

A significant number of contracted providers refer members to out-of-network laboratories. This puts members at risk of having to pay higher costs. Since the tests are available at network labs, these additional costs are unnecessary. Follow the dictates of your provider agreement and the directions in our provider manuals, which instruct you to refer these members to network labs.

Our goal is to:

• Give your patients convenient access to high-quality, cost-efficient toxicology testing services that meet their clinical needs.
• Help our members avoid higher copayments and other out-of-pocket costs that may result from using out-of-network labs.

You can confirm which labs are in-network or out-of-network as follows:

Blue Cross PPO

• For salaried employees covered through Ford, General Motors and the Michigan Public School Employees' Retirement System, call Quest Diagnostics™ at 1-866-697-8378.
• For all other Blue Cross PPO members, use the Blue Cross online provider directory.

Blue Cross Medicare Plus Blue PPO
Call either of the following resources:

• Joint Venture Hospital Laboratories — 1-800-445-4979
• Quest Diagnostics — 1-866-697-8378
  

BCN HMO and BCN Advantage

• Call Joint Venture Hospital Laboratories at 1-800-445-4979.

Contacting PARS
If you need more help locating a network lab or want to discuss specific lab testing needs, call one of the following Provider Automated Response System numbers during business hours:

Blue Cross PPO, BCN HMO or BCN Advantage

• Professional providers — 1-800-344-8525
• Facility providers — 1-800-249-5103

Blue Cross Medicare Care Blue PPO

• 1-866-309-1719

After confirming member benefits using the automated system, you can speak to someone in Provider Inquiry to get help finding an in-network lab.