Blue Cross, Blue Shield
January 2023
JAN2023 - The Record **
TOP ARTICLES:
Follow tips for checking claims-related activities
Members enrolled in Healthy Blue Choices POS don't need referrals to specialists
2023 early-release CPT Category III code update: new codes added
BCN
January February 2023
January February 2023 BCN Provider News **
TOP ARTICLES:
Farewell, web-DENIS; Hello Availity Essentials
Billing changes coming for COVID-19 treatment protocols
Prior authorizations & billing reminders for SNF interrupted stays
2022 DECEMBER 6 - PROVIDER ALERT
On Dec. 6, 2022, we posted a provider alert that tells providers that when submitting BCN Advantage claims for professional services, they must include the rendering provider taxonomy code on the claim along with the billing provider taxonomy code.
Professional claims submitted without the rendering provider taxonomy code will be denied. Providers will need to resubmit them with the rendering provider taxonomy code included.
Review the entire provider alert for additional details. It's available on our secure Provider Resources site, which is accessible through Availity.
BCC
FEB 2022 - Upcoming COVID-19 Vaccine Community Clinics
Here is the link to Michigan.gov site for all state-wide locations
Aetna
Aetna FDR Training Requirements
First Tier, Downstream and Related Entities (FDRs) must provide general compliance and fraud, waste and abuse training to employees within 90 days of initial hiring and annually thereafter. Click here for more information about it.
Aetna News
There are separate fax lines for Aetna Better Health of Michigan members and Michigan Medicare-Medcaid Plan members for authorization requests.
For ABH, which includes HealthyMI and MI Medicaid submit request: 1-866-603-5535
For Michigan Medicare-Medicaid Plan (MMP) member, which includes MI Health Link Medicare and MI Health Link Medicaid: 1-844-241-2495
LINK TO Aetna Better Health of Michigan provider site
Aetna Provider Manuals
Medicaid-Medicare - link
Medicaid -link
They also publish a Resource Sheet that you would want to print out - link
Humana
New Humana Provider Manual
Physician, Hospital and Healthcare Provider Manual all in one - link
Molina
Web Portal Quick Reference Guide
This is a great resource to guide you through using Molina's Web Portal. It is a comprehensive guide that not only includes how to access claims, appeals and a member roster plus much more!
Meridian
Check back for more information
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Site Content
Priority Health Statewide Provider Network Leadership Forum
We want to share the video of this event that occurred November 2022. Link
Some Important Links
2023 Commercial and Medicare product information for providers guide (pdf)
This link provides a link to previous Physician & Practice News as well as the Medicare/Medicaid Quality newsletters.
There are several videos that can help you with various topics. Click here to find information on:
- GuidingCare training
- PCP Incentive program training
- Provider Tools
- Video Archive
HAP Empowered
Reliance working on contract as you read this!
We are currently in negotiations to get just the right contract for you and your practice! Please contact Shawn Williams if you are interested in the timeline and details. He can be reached at swilliams@commonwealthcare.org or call 248-957-6726