The Record

Updated: Refer our members to network DME suppliers only

We’ve updated this article since it ran in the July edition of The Record. Please use this version as your reference on this topic.

What you need to know

When obtaining durable medical equipment for Blue Cross Blue Shield of Michigan and Blue Care Network members, health care providers are contractually obligated to obtain equipment from network suppliers. Otherwise, members may be responsible for the costs that arise from using an out‑of‑network supplier.

When obtaining durable medical equipment, or DME, for our members, you must use suppliers that are part of the Blue Cross Blue Shield of Michigan or Blue Care Network supplier network. Your contract with us obligates you to do this. The only exceptions are for emergencies or for other situations described in our policies.

Here are two guidelines to keep in mind:

Don’t refer our members to DME suppliers who are outside of our network.

Be sure you determine whether a particular DME supplier participates with the member’s plan before referring a member to the supplier.

Identifying a Blue Cross and BCN network DME supplier

For all members, you can find a Blue Cross and BCN network DME supplier by using the Find a Doctor tool on bcbsm.com.

Identifying a Northwood network DME supplier

For some members, you must use a supplier that’s part of the Northwood, Inc., network, which is a subset of our general DME supplier network. This applies to:

Fully insured Blue Cross commercial members

Medicare Plus Blue℠ members

BCN commercial members

BCN Advantage℠ members

You can find a Northwood DME supplier by using the Find a Doctor tool on bcbsm.com and filtering your search by “Northwood Provider.”

For additional help identifying a supplier in the Northwood network, call Northwood at
1‑800‑393‑6432.

What happens when you use an out‑of‑network DME supplier

When you use out‑of‑network DME suppliers, members may be responsible for additional out‑of‑pocket costs. They may also be subject to balance‑billing by the suppliers because the suppliers aren’t in the Blue Cross or BCN network or aren’t following medical necessity requirements for replenishing supplies.

Our goal

Our goal is to partner with you to ensure that our members have convenient access to appropriate high‑quality, cost‑effective DME supplies that meet their clinical needs and that are covered by the plan they have.

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 2020 American Medical Association. All rights reserved.