BCBSM/BCN Dual Header The Record Header Logo

The Record - Insurance Card with the BCBSM/BCN Cross and Shield logo that reads, Blue Cross Blue Shield, Blue Care Network of Michigan. Tagline: Confidence comes with every card. Image of Note boards with paper that has the letters RX on it accompanied by a stethoscope

Forward to a friend  |  Subscribe  |  The Record Archive  |  Contacts  |  bcbsm.com  |  Print this article
September 2018

What’s happening with the Provider Inquiry automated response system?

Over the past year, we’ve been updating Provider Inquiry’s automated response system to better serve you. With the increase in usage, we’ve also received a lot of great feedback and suggestions. Based on your feedback, we’ve made several updates.

Inquiries about eligibility
As of early August, when you call for eligibility and benefits, and the system doesn’t find any active coverage, you’ll hear the following:

  1. The date the policy became inactive
  2. You’ll be asked if your inquiry is about a claim:
    • If your response is “yes,” the system will ask for more information related to the claim so the call can be handled appropriately and routed correctly.
    • If the response is “no,” the system will tell you to check with the member to determine their medical coverage.
  3. The option to request information on another contract

Updates coming in September

Old automated response

New automated response

How will it help?

“Are you calling on behalf of a Michigan member?”

“Are you calling on behalf of a member who has a Blue Cross Blue Shield of Michigan ID card? Please say ‘yes’ or ‘no’.”
  • It will give you clearer understanding of the question
  • It will route your call correctly

“Are you calling for a status on your claim?”

“If you know the outcome of your claim, but have additional questions about the determination, say ‘yes’ otherwise, say ‘no’.”
  • It will give you clearer understanding of the question
  • It will lessen the amount of time you need to spend in the automated response system

We always appreciate your feedback. Please contact Provider Servicing if you have any suggestions or questions about the automated response system.

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 2017 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.