Blue Cross Blue Shield of Michigan Blue Care

Blue Cross Blue Shield of Michigan/ Blue Care Network Lakeland Payor Conference October 16, 2019 Blue Cross Blue Shield of Michigan is a nonprofit corporation and independent licensee of the Blue Cross and Blue Shield Association.

Provider enrollment bcbsm. com/providers Click the Enroll to become a provider green button 2

Signing up for online tools Select either • Modify your account • Register 3

Tools and resources Provider Secured Services • web-DENIS • e-referral • Online payments and electronic vouchers • Medical drug prior authorization • Health e-Blue. SM Click here for a 20 -minute Brain. Shark training video on all of the tools available on Provider Secured Services 4

web-DENIS • Broadcast Messages • Blue Cross/BCN/Medicare Advantage updates and alerts • BCBSM Provider Publications and Resources • BCN Provider Publications and Resources • Provider Manuals • Professional and Facility Claims • Contact Us web-DENIS training Brainshark link 5

Subscriber info. Eligibility / Coverage • Enter patient contract number • Select correct radio button • Eligibility will appear based on coverage • Green box = Active • Red box = Inactive • Coordination of Benefits coverage can be viewed 6

BCBSM Provider Publications and Resources Includes • Provider newsletters • Training resources • Pharmacy resources • Provider Manual links • Benefit Policy link • Fee schedules • Pre-Auth Router 7

Newsletters and Resources • • The Record Products and Networks Provider Manuals Provider Training Fee Schedules Clinical Criteria Forms 8

Provider manuals 9

Medical Policy & Pre-Cert/Pre-Auth Router • Gives authorization requirements for other Blue Cross Association Plans • Blue Plan Websites vary • Call 1 -800 -676 -BLUE to be routed to home plan 10

BCN Provider Publications and Resources Click on link located on web-DENIS home page to access BCN Provider Publications and Resources 11

Links Click links on the left hand side to access important BCN information. Includes information for BCN HMO (commercial) and BCN Advantage. 12