Starting Jan. 1, Northwood is Blue Cross’ DME/POS program benefits manager

Starting Jan. 1, 2021, Northwood Inc. will administer and manage all aspects of durable medical equipment, prosthetics, orthotics and medical supply benefits for Blue Cross Blue Shield of Michigan commercial fully insured and individual members who reside in the state of Michigan.

Only members in groups enrolled in the program are required to participate. Blue Care Network, BCN Advantage℠, and Medicare Plus Blue℠ are already part of the tailored network arrangement with Northwood.

Northwood will administer:

• Prior authorizations
• Member services
• Claims payments
• Provider appeals, contracting, management and training
  

DME/POS program categories and examples of services include:

Standard equipment

• Requires little or no servicing by the member or provider
• CPAP, walkers, canes, crutches and commodes

Labor-intensive equipment

• Requires frequent servicing by trained professionals
• Oxygen or respiratory equipment, custom rehabilitation

Body supports and limbs

• Specifically fitted for the member’s needs
• Cervical collars, braces and limb replacement (prosthetics), orthotics

Medical or surgical supplies

• Essential for use with covered equipment
• Diabetic supplies, dressings, ostomy and urological

Prior authorization

• Out-of-state claims will go through NASCO and don’t require Northwood prior authorization.
• Northwood will be handling DME/POS prior authorization decisions.
• Northwood’s benefit coordinators will be your initial contact for requesting a prior  authorization.
• If product or service can’t be authorized by a benefit coordinator because it doesn’t immediately meet criteria, it’ll go to Northwood’s Case Review department.
• If Northwood’s medical director determines that the requested equipment or service doesn’t meet medical criteria, Northwood will issue a denial to the provider and member.

Participation
Blue Cross' DME/POS providers can contract with Northwood to provide these services to our commercial PPO membership. This includes providers already in the Northwood network.

If you’re interested in applying to the Northwood network, contact Northwood Provider Relations at 1‑800‑447‑9599 between 8:30 a.m. and 5 p.m. Eastern time Monday through Friday. Or email provideraffairs@northwoodinc.com.

You may also fill out an application online at northwoodinc.com.**

Additional information
For more information about the DME/POS program and how it works, refer to the following documents at bcbsm.com/providers:

• Northwood DMEPOS Management Program FAQ
• Northwood DMEPOS Management Program: Procedure Codes Requiring Prior Authorization

If you have additional questions about the DME/POS management program, contact Northwood Provider Relations at 1-800-447-9599 between 8:30 a.m. and 5 p.m. Eastern time Monday through Friday.

**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.