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January 2019

Reminder: Update TPA, Provider Authorization Form when making changes to trading partner information

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 electronic data interchange setup process. All EDI trading partners must complete both 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. You must update your Provider Authorization Form if you send claims using a different submitter ID or route your Electronic Remittance Advice, or 835s, to a different unique receiver or trading partner ID. Updating the form ensures information is routed to the appropriate destination.

Any time you switch vendors, billing services or clearinghouses, you need to update your Provider Authorization Form.

To make changes to your EDI setup:

  • Go to bcbsm.com.
  • On the homepage, select Providers.
  • On the Providers page, select Quick Links under Welcome to Provider Services.
  • Click on Electronic Connectivity (EDI) from the list of links and then select How to use EDI to exchange information with us electronically.
  • Select Update your Provider Authorization Form in the middle of the page under EDI Agreements.

You should review your provider authorization information if you’ve:

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

For questions about EDI enrollment, contact our help desk at 1-800-542-0945. For assistance with TPA and Provider Authorization forms, select the TPA option.

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 2018 American Medical Association. All rights reserved.