For Providers: Forms and documents - BCBSM
If you're a provider in Michigan, find your Blue Cross Blue Shield forms, drug lists and medical record retrieval documents.
Clinical Editing Appeal Form As an alternative, you can submit appeals electronically. For BCN commercial, BCN AdvantageSM, Blue Cross commercial and Medicare Plus BlueSM 2. Check the box to indicate the appropriate line of business and refer to the associated information:
For Providers: Medicare appeals - BCBSM
Blue Cross' Medicare Advantage PPO providers should follow the guidelines on this page when submitting an appeal. Michigan providers can either call or write to make an appeal or file a payment dispute.
Blue Cross Blue Shield of Michigan is an independent licensee of the Blue Cross and Blue Shield Association . MEMBER APPEAL FORM. Blue Cross Blue Shield of Michigan will accept your request for an appeal when the request is submitted within. 180 days from the …
For providers not contracted with Blue Cross or BCN Providers who are not contracted with Blue Cross or BCN should follow these instructions: • For Medicare Plus Blue claims, submit clinical editing appeals to: Blue Cross Blue Shield of Michigan Medicare Plus Blue Grievance and Appeals Department P.O. Box 2627 Detroit, MI 48231-2627
The Record - We're simplifying provider appeals process - BCBSM
Send the written appeal request or the completed Provider Appeal Form and all supporting documentation by fax to 1-877-348-2210 or by mail to: Blue Cross Blue Shield of Michigan Provider Appeals — Mail Code CS3A
Resolving Problems for PPO and Traditional Members | BCBSM
If your health plan requires you to get approval for certain health services before receiving them and you disagree with Blue Cross Blue Shield of Michigan's decision not to approve a service, you have the right to appeal it.
Resources | Providers - BCBSM
Find the resources you'll need to help care for your Blue Cross Blue Shield of Michigan and Blue Care Network patients. Key forms and documents These commonly used documents can help you complete your tasks.
Use the Medical Record Claim Attachment Form when mailing or faxing paper medical records to Blue Cross Blue Shield of Michigan in response to a denied claim. If you have this location bookmarked, please update the bookmark.
designation of authorized representative for appeal Use this form to authorize an individual tocommunicate on your behalf with Blue Cross Blue Shield of Michigan on a one-time basis about the specific appeal.