Reminder: Participating providers may only bill members for applicable deductibles and copayments

We want to remind participating providers that they must bill Blue Cross Blue Shield of Michigan and Blue Care Network for all covered services and may only bill members for applicable deductibles and copayments. In keeping with provider contracts, you may not collect deposits or bill members upfront for unpaid balances of covered services.

The following guidance comes from the “Patient Copayment and Deductibles” chapter of the Blue Cross Provider Manual.

• Verify member copayments and deductibles through web‑DENIS or Provider Inquiry before collecting them.
• Collect known cost‑sharing amounts, such as copayments and unmet deductibles, up to the amount of the member’s liability.
• You may not collect the difference between the Blue Cross approved amount and provider charges, also referred to as balance billing.
• Don’t mandate that patients provide credit card information to secure any future balance. (Patients may voluntarily do so.)