Reminder: Participating providers may only collect applicable deductibles, copayments from members upfront

We want to remind participating providers that you must bill Blue Cross Blue Shield of Michigan and Blue Care Network for all covered services and may only bill members for their 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 Deductible Requirements” chapter of the Blue Cross Commercial Provider Manual.

• Verify member copayments and deductibles through our provider portal Availity Essentials™ 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.)

Availity^® is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal and electronic data interchange services.