Reliance Physician Organization of Michigan
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    • Home
    • About
    • News
      • Insurance Resources
      • COVID19 Resources
      • Recent Coding Updates
    • PROVIDER SERVICES
      • Insurances Offered
      • Membership
      • PCMH
Reliance Physician Organization of Michigan
  • Home
  • About
  • News
    • Insurance Resources
    • COVID19 Resources
    • Recent Coding Updates
  • PROVIDER SERVICES
    • Insurances Offered
    • Membership
    • PCMH

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

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 CCA Health Physician Organization 

23900 Orchard Lake Rd.

Suite 50, Back Entrance

Farmington Hills, Mi 48336

(248) 987-6097


Copyright © 2022  CCA Health Physician Organization - All Rights Reserved.



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