10/13/2025

BCBSM/BCN

Recent Oncology Related News

Blue Cross Blue Shield / Blue Care Network Managed Care Committee Members:

Vernell Hester, COC, CHONC - Downriver Oncology Center

Starting Oct. 6, Submit Prior Authorization Requests for FEP Members Through the E-Referral System
Starting Oct. 6, 2025, health care providers can submit prior authorization requests for members who have coverage through the Blue Cross and Blue Shield Federal Employee Program through the e-referral system. This change applies to procedures that are managed by Blue Cross Blue Shield of Michigan and affects FEP members who have both commercial and Medicare Supplement plans.

This change will benefit you by:

• Enabling you to submit prior authorization requests for FEP members in the same way you submit requests for other Blue Cross members
• Helping to decrease the time it takes for Blue Cross to process prior authorization requests
• Enabling you to quickly and easily check the status of prior authorization requests through the e-referral system
• Enabling you to communicate with Blue Cross staff through the Case Communication field in the e-referral system

READ MORE 

New Provider Prior Authorization Website Launches October 22

On Wednesday, Oct. 22, we will launch the new Provider Prior Authorizations website, located at authorizations.bcbsm.com. This website will replace ereferrals.bcbsm.com and offer a more intuitive and user-friendly experience for providers. Information on referrals, prior authorizations and plan notifications will still be found in one place by using this new website.

READ MORE. 

Reminder Regarding the Collection of Applicable Deductibles, Copayments from Members Upfront
Participating providers must bill Blue Cross Blue Shield of Michigan and Blue Care Network for all covered services and may only bill members for their applicable deductibles and copayments. In keeping with provider contracts, you may not collect deposits or bill members upfront for unpaid balances of covered services.

The following guidance comes from the “Patient Copayment and Deductible Requirements” chapter of the Blue Cross Commercial Provider Manual.

• Verify member copayments and deductibles through the provider portal Availity Essentials or Provider Inquiry before collecting them.
• Collect known cost-sharing amounts, such as copayments and unmet deductibles, up to the amount of the member’s liability.
• You may not collect the difference between the Blue Cross approved amount and provider charges, also referred to as balance billing.
• Don’t mandate that patients provide credit card information to secure any future balance. (Patients may voluntarily do so.)

BCN Advantage Update: Office, Outpatient E/M Visit Complexity Add-On Code G2211
In June, Blue Care Network communicated that the Centers for Medicare & Medicaid Services added information on how to use procedure code G2211 with modifier 25 for certain Medicare Part B services starting Jan. 1, 2025, and that their systems were updated to accommodate the changes in May 2025. System updates occurred later than initially communicated, but were completed in June. The affected claims, which were professional claims, will be reprocessed.

To avoid duplicate claim denials and delayed processing, don’t resubmit claims. Please allow up to eight weeks for reprocessing of affected claims.

Webinars for Physicians, Coders Focus on Documentation, Coding
In 2025, we’ll continue to offer webinars about documentation and coding of common challenging diagnoses. These live, lunchtime educational sessions will also include an opportunity to ask questions.

Below is our schedule and topics for the sessions. All sessions start at noon Eastern time and should last for 30
minutes. Register for the sessions on the provider training website.

Provider training website access
If you have an Availity Essentials™ account, you can access the provider training website this way:

1. Log in to the provider portal at availity.com.
2. Click on Payer Spaces on the menu bar, and then click on the BCBSM and BCN logo.
3. Under Applications, click on the Provider Training Site tile.
4. Click on Submit on the Select an Organization page.

Existing users who used the same email address as their provider portal profile email will be directed to the training site. If you used a different email address, contact ProviderTraining@bcbsm.com to update your profile.

You can also directly access the training through the Provider training website.

After logging in to the provider training website, look in Event Calendar to sign up for your desired session. You can also quickly search for all the sessions with the keyword “lunchtime” and then look under the results for Events. 

You can listen to the previously recorded sessions, too.

Questions?
For more information about the sessions, contact April Boyce at aboyce@bcbsm.com.

For more information about registration or using the provider training website, contact the provider training team at ProviderTraining@bcbsm.com.