01/19/2023

New Blue Cross® Local HMO and BCN Advantage℠ Local HMO

ONLY Ascension and Trinity physicians will be part of the new Local HMO plans

As previously announced in the November-December 2022 issue of BCN Provider News on pages 3 and 8, Blue Cross Local HMO and BCN Advantage Local HMO are new products that are part of a new 2023 Local network available to Michigan residents in Macomb, Oakland and Wayne counties. Members must select a primary care physician within the Local network of physicians and hospitals affiliated primarily with Ascension and Trinity Health.

Members must receive services within this Local network. The primary care physician coordinates care with the network specialists and hospitals. If a member needs services found outside the network, BCN authorization is required for the member to receive care. BCN will only authorize the service if it is something that can’t be performed within the network. Standard BCN clinical review requirements apply.

Referrals are handled like other similar BCN health plans.

• Blue Cross Local HMO, a BCN commercial health plan in the Southeast region, requires primary care physicians to submit referrals through the e-referral system.
• BCN Advantage Local HMO, a BCN Advantage health plan, does not require referrals to be submitted through the e-referral system, but still expects the primary care physician to coordinate care. 

To see a list of participating hospitals and medical care groups, check your network status or see images of the member ID cards, please see the Blue Cross Local HMO and BCN Advantage^SM Local HMO flyer (PDF). You can also find this flyer on our provider portal:

1. Log in to our provider portal (availity.com).
2. Click Payer Spaces on the Availity menu bar.
3. Click the BCBSM and BCN logo.
4. Click Secure Provider Resources (Blue Cross and BCN) on the Resources tab.
5. Choose BCN or BCN Advantage from the Products dropdown menu.