Billing CUSTOM P&O to BCBSM?

As of September 1st, all providers billing custom prosthetics & orthotics to Blue Cross Blue Shield of Michigan will be required to submit those claims with a separate CMS accredited PIN. If you are facing this challenge or one like it, here's how we'd recommend you handle it in HDMS.  

STEP 1: Create a New Provider Entry Create a NEW provider for P&O in the Provider Table and label it as such.  Ex. “Prosthetics/Orthotics- Blue Cross Blue Shield”. Set this up as you would any other provider. Once this is created move to step 2.

STEP 2: Update Payer In the payer table for the BCBS payer that will be effected, go to the misc settings tab, Select the NEW provider that was just created. Enter your P&O TAXONOMY code required by BCBS and any other information needed (like your BCBSM PIN in the Number Field), click, Save.


PLEASE INSTRUCT STAFF: The CSR/Orthotist/QA, will need to pick the new provider when creating/confirming the P&O order, this will send the correct PIN with the claim.