Blue Cross Blue Shield of Michigan Blue Care

Blue Cross Blue Shield of Michigan Blue Care Network Lakeland Care Network Payor Conference October 18, 2017 Katie Rogers and Kathy Fletcher Provider Relations Consultants Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

Resources / Tools www. bcbsm. com/providers Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

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

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

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

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

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

Enrollment / Credentialing Helpful tips: • Keep Council for Affordable Quality Healthcare® Pro. View ® information current, and complete your re-attestation every 120 days. • Update “Authorize” section on CAQH. • Maintain current board specialty and certification status on CAQH. • Designate your primary specialty on CAQH with care and consideration. • Provide CAQH with a current malpractice insurance face sheet. • Require your malpractice carrier to submit your liability insurance information in a timely manner. • If practicing exclusively in an inpatient hospital setting, be sure to update CAQH accordingly. • New graduates should wait until 60 days prior to completing training before submitting their application. • Practitioners relocating from out of state can submit their application 30 days prior to their start date. • Be sure to sign and include all required signature documents Requesting a status: Practitioners currently being credentialed or recredentialed may request the status of their application by contacting the Provider Enrollment and Data Management department. Have the following items ready: • National Provider Identifier • Tax ID/Social Security number • Primary address and phone number Provider Enrollment and Data Management (PEDM) 1 -800 -822 -2761/fax 1 -866 -900 -0250 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. CAQH help desk 1 -888 -599 -1771

Provider Enrollment Self Service As of January 1, 2018 the Group Change Form is being replaced with the Provider Enrollment and Change Self-Service tool on the Blue Cross Blue Shield Michigan's Provider Secured Services. Group Administrators and their designated staff with responsibility for maintaining professional group data will need to request access to the tool. If your group hasn't used Provider Secured Services, you'll need to complete and submit all three documents below. If your group has access to Provider Secured Services and you have additional new users, complete documents 1 and 2 below. If your group has access to Provider Secured Services and the user(s) already has a Provider Secured Services User ID and only needs access to the Self. Service tool, complete and submit document 2(Addendum G) below. 1 - Professional Secured Access Application 2 - Addendum G 3 - Use and Protection Agreement Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

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

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

Standard ID Cards See Blue Cross Blue Shield of Michigan and Blue Care Network specific ID Card Brochures for more detailed information. 12 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

Summary of changes to BCBSM Prior Auth Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

Prior Authorization AIM Specialty Health www. aimspecialtyhealth. com 1 -800 -252 -2021 Blue Cross Blue Shield Michigan PPO and Medicare Plus Blue Evicore www. evicore. com 1 -855 -774 -1317 Blue Care Network / Blue Care Network Advantage and Medicare Plus Blue e-referral www. ereferrals. bcbsm. com 1 -800 -392 -2512 Blue Care Network / Blue Care Network Advantage and Medicare Plus Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

E-referral www. ereferrals. bcbsm. com Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

Who to call Provider Inquiry BCBSM / BCN Professional BCBSM / BCN Facility Federal Employee Program BCBSM Medicare Advantage EDI – front end rejection on claim Blue. Card (BCBSM and MA) Web. Denis / Provider Secured Services 1 -800 -344 -8525 1 -800 -249 -5103 1 -800 -840 -4505 1 -866 -309 -1719 1 -800 -542 -0945 1 -800 -676 -BLUE (2583) 1 -877 -258 -3932 If you have contacted the above areas without resolution, the Provider Relations department will be more than happy to assist. Please provide the name of the person/department you spoke with so we don’t duplicate efforts. BCBSM Professional Claim Specialist: BCBSM Facility Claim Specialist: BCN/BCNA Specialist: BCBSM/BCN Professional Provider Consultant Katie Rogers krogers 2@bcbsm. com Ph: 269 -321 -7677 Sarah Pike at 616 -389 -2119 or spike@bcbsm. com Jeff Munn at 616 -389 -2116 or jmunn@bcbsm. com Jennifer Gallandt at 616 -389 -2136 or jgallandt@bcbsm. com BCBSM/BCN Facility Provider Consultant Kathy Fletcher kfletcher@bcbsm. com Ph: 616 -389 -2049 Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

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