The Record

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

Subscribe | The Record Archive | Contacts | bcbsm.com

October 2018
Picture of physician

We’re enhancing our self-service tools to better meet your needs
We’re expanding our self-service offerings to help meet your business needs. This includes changes to the Provider Automated Response System, or PARs, and Provider Secured Services. Read more.

Inside this issue for you

See all the articles in this issue, grouped by category, below.

Professional

We’re simplifying provider appeals process
Physicians, Blue Cross and BCN agree that healthy lifestyles are key to living well
Fit4D: New diabetes education program for eligible members
Cancer screening saves lives: Here are some recommendations
Coding corner: Documenting ulcers of the skin
Most providers are missing out on medication reconciliation reimbursements. Are you?
New user-friendly prompts coming to Pharmacy Prior Authorization Help Desk
Upcoming changes for home infusion therapy and ambulatory infusion center providers
We no longer cover Clindagel^®
Members can no longer receive prescriptions for DME/P&O items through telehealth visits
URMBT to participate in medical drug prior authorization program
New utilization management programs beginning for URMBT members
Don’t forget to update your Provider Authorization Form when changes occur with your 835 (ERA) routing destination

All Providers

We’re enhancing our self-service tools to better meet your needs
Are you getting paid for following best practice guidelines for rheumatoid arthritis?
Resources can help you promote suicide awareness and prevention
Next Drug Take Back Day scheduled for Oct. 27
Blue Cross PPO members who live outside Michigan will need prior authorization for certain services
2019 early release CPT code updates
Billing chart: Blues highlight medical, benefit policy changes

Pharmacy

New user-friendly prompts coming to Pharmacy Prior Authorization Help Desk
Upcoming changes for home infusion therapy and ambulatory infusion center providers
We no longer cover Clindagel^®
URMBT to participate in medical drug prior authorization program
Overview of correct pharmacy benefit billing for Cimzia, Enbrel, Victoza

Facility

New user-friendly prompts coming to Pharmacy Prior Authorization Help Desk
New utilization management programs beginning for URMBT members
Don’t forget to update your Provider Authorization Form when changes occur with your 835 (ERA) routing destination
We’re updating facility billing policy on multiple surgery reimbursement with nerve block procedure
FEP billing guidelines for physical, speech and occupational therapy at skilled nursing facilities

DME

Members can no longer receive prescriptions for DME/P&O items through telehealth visits

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.

Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

We respect your right to privacy - view our policy.