Medicare Advantage PPO contract amendments

Blue Cross Blue Shield of Michigan amends the following sections of the Medicare Advantage PPO Provider agreement (PDF):

• Section 5.1 (Acceptance of Payment) to recognize that settlements may occur for certain provider types
• Section 5.3 (Timely Submission of Claims) to include a 27-month claims filing limitation
• Adds a new section 5.7 entitled "Services Rendered by Non-Physician Providers"

BCBSM amends the following sections of the BCBSM MA PPO Provider Agreement Hospital Attachment (PDF):

• Sections 1.a. and 1.b. (Acute Inpatient and Outpatient Services) to clarify that BCBSM's MA PPO payment settlement process is not limited to Critical Access and Sole Community hospitals
• Section 2.a. (Swing Beds) to clarify how payment is made for swing beds in Critical Access Hospitals vs. non-Critical Access Hospitals