BCN Provider Resource Guide
bcbsm.com | ereferrals.bcbsm.com April 2018 Behavioral Health Benefits and Eligibility Claims Coordination of Benefits Customer Service DME, Medical Supplies and P & O Health & Wellness Laboratory Services Musculolskeletal Services Pharmacy Services PT, OT and ST Provider Enrollment and Change Requests Provider Inquiry Provider Outreach
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Service Contact Information - e-Referral
ereferrals.bcbsm.comBlue Cross provider resource guide at a glance Find more information in the Blue Pages Directory chapter of the Blue Cross PPO Provider Manual: Visit bcbsm.com, log in to Provider Secured Services and click Provider Manuals.
Service Contact Information - Blue Cross Blue Shield …
ereferrals.bcbsm.comBlue Cross provider resource guide at a glance Find more information in the Blue Pages Directory chapter of the Blue Cross PPO Provider Manual: Visit bcbsm.com, log in to Provider Secured Services and click Provider Manuals.
BCN Referral and Authorization Requirements
ereferrals.bcbsm.comChanges from previous publication are identified by a Blue Dot and explained on the final page of this document. Page 1 of 10 Revised for June 1, 2018
BCN Provider Inquiry Contact Information - e …
ereferrals.bcbsm.comProvider Inquiry Contact Information For BCN HMOSM (commercial) and BCN AdvantageSM Behavioral Health For…During business hours…* After business hours… Physician-to-physician review of determination
CT of the Abdomen OR CT Abdomen and Pelvis - e …
ereferrals.bcbsm.comRadiology Questionnaire January 2014 . CT of the Abdomen OR CT Abdomen and Pelvis . Providers can expedite a request by submitting a prior authorization request through e-referral and completing the
Blue Care Network e-referral User Guide
ereferrals.bcbsm.comDear Blue Care Network Health Care Service Provider: Welcome to e-referral on iEXCHANGE®, BCN’s Web-based referral and authorization system. Now that you have signed up to use e-referral, you are on
Detailed Explanation of Non-Coverage Instructions
ereferrals.bcbsm.comForm Instructions for the Detailed Explanation of Non-Coverage (DENC) CMS-10124 . A Medicare provider/health plan (“plan”) must provide a completed copy of this notice to
BCN Behavioral Health Continuing OTR Form - e …
ereferrals.bcbsm.comBCN Behavioral Health Continuing Outpatient Treatment Request Form . Member number: Member name: Member DOB: Attach completed form to the case
Changes from previous publication are marked with a Blue ...
ereferrals.bcbsm.comServices That Require Authorization Authorization requirements for members with Blue Cross Medicare Plus BlueSM PPO or Blue Cross Medicare Plus BlueSM Group PPO coverage For more complete information about care management and utilization management requirements, refer to the Blue Cross Medicare Plus Blue PPO Provider Manual. Section 2: Codes for procedures that require authorization
Nuclear Scan of Biliary Tract/Hepatobiliary Duct
ereferrals.bcbsm.comRadiology Questionnaire . Nuclear Scan of Biliary Tract/Hepatobiliary Duct (HIDA) Providers can expedite a request by submitting a prior authorization request through e …
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Behavioral health documentation requirements and privacy ...
ereferrals.bcbsm.comBehavioral health medical record documentation requirements and privacy regulations — for services other than ABA page 4 September 2017 For Blue Cross PPO (commercial), Blue Cross Medicare Plus BlueSM PPO, Blue Care Network HMOSM (commercial) and BCN AdvantageSM members HIPAA privacy regulations and documentation — for all non-ABA services by all …
Instructions for document submission - bcbsm.com
www.bcbsm.comType 2 NPI (National Provider Identifier) Tax identification number For professional group practices and facilities From (Insert name of contact person) Date (MM/DD/YYYY) Type 2 NPI (National Provider Identifier) Tax identification number Instructions for document submission 1. Fax cover sheet must be the first page of your form submission. 2.
Professional Secured Access Application - BCBSM
www.bcbsm.comProvider Group, Individual Provider, and/or Provider Organization) am responsible for all actions undertaken by the listed individuals. Note: This is an Addendum to the Provider Secured Services Use and Protection Agreement and does not alter the terms set forth therein.
Submitting Electronic Replacement and/or Void Claims
www.bcbsmt.comFor electronic professional and institutional claims (837P and 837I transactions), it is important to use the appropriate Claim Frequency Code in CLM05-3 to indicate the claim is a correction of a previously adjudicated (approved or denied) claim. The valid claim frequency codes are: 1 Indicates the claim is an original claim