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DME/P&O, medical suppliers and pharmacists
Blue Cross Blue Shield of Michigan contracts with DMEnsion Benefit Management to process and service claims for all codes with regional carrier jurisdiction and to provide a network for Medicare Plus Blue PPOSM members.
See the Centers for Medicare & Medicaid Services' jurisdiction list (PDF) of codes to determine where claims should be sent.
| CMS jurisdiction | Send claims to... |
|---|---|
|
All providers when treating Medicare Plus Blue members DME regional carrier jurisdiction |
|
|
All providers Local carrier jurisdiction |
Your local Blue plan |
| Michigan providers when treating another Blue plan's Medicare Advantage member | BCBSM |
Pharmacists
See our frequently asked questions brochure (PDF) for more information.
Reimbursement
When treating members who use DMEnsion's network, network health care providers are reimbursed according to the DMEnsion Benefit Management-contracted amount.
Out-of-network reimbursement for Medicare Plus Blue PPO
Out-of-network claims for Medicare Plus Blue PPO members will be reimbursed using the CMS reimbursement guidelines with a higher level of member cost-sharing applied.
