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November 2022

For some providers, process for updating your information with us changing in November

Starting Nov. 3, 2022, you may need to complete two forms to update any of the following information in the Blue Cross Blue Shield of Michigan and Blue Care Network online provider directory:

  • Name
  • Specialty
  • Address
  • Telephone number
  • Digital contact information

We’re changing the process of updating information to comply with provisions of the Consolidated Appropriations Act, or CAA, of 2021.

Types of providers affected

This change will affect all providers except:

  • Hospitals
  • Group and individual providers

What you need to update

When making a change, refer to the table below:

Information you’re updating

Form(s) to complete

Only your name, specialty, address, telephone number and/or digital contact information

Complete the new Provider Directory Change Form.**

Information other than the items listed above

Complete one of the following currently used forms:

  • Facility providers: BCBSM/BCN Facility Change Form
  • Allied providers: Allied Provider Change Form

Updates involving both:

  • Your name, specialty, address, telephone number and/or digital contact information
  • Information other than the items listed above

Complete two forms:

  • The new Provider Directory Change Form
  • The currently used BCBSM/BCN Facility Change Form orthe Allied Provider Change Form, as appropriate

**You’ll find a link to the new Provider Directory Change Form near the links to the BCBSM/BCN Facility Change Form and the Allied Provider Change Form.

Accessing the forms

To access the forms, follow these steps:

  1. Visit bcbsm.com/providers.
  2. Click on Enrollment.
  3. Click on Enroll Now.
  4. Follow the prompts.

Fax the completed forms to the Provider Enrollment department at 1-866-900-0250. This fax number is shown on each form.

Need help?

For assistance completing the correct forms, call the Provider Enrollment department at 1-800-822-2761.

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 2021 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.