Medical Plan Contact InformationBelow is a list of key contact numbers for medical plans available to Trinity Health colleagues (plans may vary by region or Ministry). Please contact the plan you selected for the current benefit year as indicated on your medical insurance ID card. Show
Aetna | Self Service InfoCenterAllows participating colleagues to: view - enrollment information, claim history, locate participating providers, request an ID card.
BCBSM | Self Service InfoCenter Allows participating colleagues to: view - enrollment information, claim history, locate participating providers, request an ID card. Limited Purpose Health Reimbursement Account (HRA) | Health Equity
Health Equity | Health Savings Plan Only
Flexible Spending Accounts | Self Service InfoCenterAllows participating colleagues to view balances, enroll in direct deposit, and determine status of claims.
Weight Management Reimbursement
OptumRx | Self Service WebsiteAllows participating colleagues to view current drug coverage, price medications, review formulary and locate participating pharmacies. Please note: this only applies to colleagues in a self insured medical plan. Customer Service 1-855-540-5950 Delta Dental | Consumer ToolkitAllows participating colleagues to: verify eligibility; review claim history and benefit information; print ID card and claim forms.
United Healthcare Vision | Member Services WebsiteAllows participating colleagues to: verify eligibility, review claim history and locate participating providers. © 2005 - 2022 copyright of Anthem Insurance Companies, Inc. Serving Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri (excluding 30 counties in the Kansas City area), Nevada, New Hampshire, Ohio, Virginia (excluding the Northern Virginia suburbs of Washington, D.C.), and Wisconsin. Sydney Care is offered through an arrangement with Carelon Digital Platforms, Inc. Sydney Health and Sydney Care are service marks of Carelon Digital Platforms, Inc., © 2022 ©2022 Empire Blue Cross Complete of Michigan's self-service tools are valuable resources that can assist you in providing the highest quality of care to our members. Provider directoriesDrug formularyA comprehensive drug list for Blue Cross Complete can be accessed and reviewed in two ways: The searchable version of the drug list provides additional details regarding quantity limits, prior authorizations or other coverage details not available on the printable version. This includes guidance for obtaining specialty medications. For pharmaciesThe PerformRx Pricing Administration Department calculates generic Maximum Allowable Cost and money paid to participating pharmacies. MAC prices are updated each week. To ask for a MAC pricing review, email the PerformRx Pricing Administration Department. You can also call PerformRx Pharmacy Provider Services at 1-888-989-0057. Prior Authorization LookupFind out if a service needs prior authorization. Type a Current Procedural Terminology, or CPT, code or a Healthcare Common Procedure Coding System, or HCPCS, code in the space below to get started. Directions
Important noticeThis tool provides general information for outpatient services performed by a participating provider. The following services always require prior authorization:
The results of this tool aren’t a guarantee of coverage or authorization. All results are subject to change in accordance with plan policies and procedures and the Provider Manual (PDF). If you have questions about this tool or a service or to request a prior authorization, call Blue Cross Complete's Provider Inquiry at 1-888-312-5713. Healthcare common procedure coding system medicationsA prior authorization for healthcare common procedure coding system medications is required before they are covered by Blue Cross Complete. Click the HCPCS PA List (PDF) for a list of codes that require prior authorization. Prior authorizationSome medicines and benefits require prior authorization by Blue Cross Complete. Submit a prior authorization request using one of the following forms:
You must submit a request for a prior authorization for your patient. You must also submit an override of a drug restriction. Request from pharmacies aren't accepted. Pharmacy billingThe electronic processing of retail pharmacy claims requires a NCPDP processor ID number, also known as a BIN, and a processor control number, or a PCN, for plan identification. Blue Cross Complete's D.0 Payer Sheet (PDF) contains our BIN (600428), PCN (06210000), member services number, field definitions and other helpful information for pharmacy claim billing and rebilling. NaviNetBy logging on to the Blue Cross Complete payer-provider portal Navinet, you have the opportunity to:
Visit NaviNet Basics if you have not yet enrolled or would like more information. Does Blue Cross Blue Shield of Michigan require prior authorization?BCBSM requires prior authorization for services or procedures that may be experimental, not always medically necessary, or over utilized. Providers must submit clinical documentation in writing explaining why the proposed procedure or service is medically necessary.
How long does prior authorization take Blue Cross Blue Shield Michigan?If you file an urgent request, we will have a decision provided in 72 hours or less. For an urgent review of a non-covered drug, one not on your drug list, we will have a decision in 24 hours or less. A standard request may take up 15 days for us to make a decision.
How do I contact Blue Cross Blue Shield of Michigan?Learn about insurance options for Individuals & Families or Employers, or get connected with your local Blue Cross Blue Shield company by calling 888.630.2583.
Is BCBS of Michigan on availity?Selecting Michigan will allow access to all available Michigan payers, including BCBS Michigan and Blue Care Network. Our office already uses Availity.
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Blue cross blue shield prior authorization form michigan
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