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News and Notes

 

Spring 2017

 

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CE Information

Spring 2017

Blue Care Network and BCBS Enrollment for LLP’s

To all LLPs:

Cindy Moore is coordinating with MAPP to help keep us informed about billing and PIN number procedures. There have been questions about BCBS/BCN issuing PIN numbers.

Please read her reply to MAPP about this issue:

To all Michigan LLP’s:

Health Care Connect is a professional credentialing and billing agency, working with both the Michigan LLP and LMFT Associations. We wanted to get information out to all of the eligible providers, about the BCN and BCBS current enrollment opportunity. On March 1, 2018, Blue Care Network began accepting enrollment applications for LLP’s, who belong to a group. This process will continue for a small window of only three months. After, May 31st, 2018, if your BCN application is not in, this window is expected to close. (BCN did the same short enrollment period in 2016 with LPC’s, when they were allowed to panel). To clarify and define the opportunity, BCN is only accepting applications for LLP’s who are either joining a group or are forming a new group that has at least one LP, on the group panel. If you are attempting to panel as a solo practitioner with BCN, your application will be returned, unless you are currently in a group and are linking to a group, for billing purposes. If you are desiring to open your own solo practice office, there is a work around to this ruling. You will have to follow the protocol below: Form a new group with BCBS/BCN Enroll yourself, as an LLP with BCN, as an individual working for the group. Enroll an LP, as an individual working for the group. #3 is where everyone is getting hung up. Technically, you no longer need a supervisor to bill BCN claims under, after 6/1/18, if you are on panel with BCN. However, BCN is STILL REQUIRING, that an LP be a part of the group, due to the licensure restrictions of LLP. If you do not have an LP in the group, your application will be returned by BCN!! We are recommending that any LLP desiring to form a solo practice, ask an LP to join their new group, so that you do not miss out on this historic opportunity. We are recommending that LLP’s ask their current LP supervisor to do them a favor, after all of the $$$ that you have paid them over the years. This LP does not have any additional liability or supervision requirements for the LLP, with BCN. BCN just wants the assurance that should the LLP have plan of care questions, that an LP is available within the group structure, to answer questions about the direction of the care plan. Technically, the LP does not need to actively see patients, nor be in the office for supervision on BCN direct bill claims by an LLP. This affiliation, can be in name only. If you would like Health Care Connect to file your applications for you, we are offering a reduced rate to the Michigan LLP and LMFT Associations. If you are linking to an existing group the fee is only $110. If you are desiring to create a new solo group, to establish your independence, three applications will need to be filed, for the cost of $330. Please contact Cindy Moore at Health Care Connect for more information or questions, 734-207-5226. In addition to clarifying the BCN questions, I also want to address the BCBS paneling. Many LLP’s are assuming that they may now see BCBS patients, directly, without supervision. I want to make it very clear that BCBS is only opening up their panel to their Traditional Network. This Traditional Network accounts for, approximately, only 2% of all of the BCBS policies out there. It will essentially, be almost useless, and is only being done because BCN requires that all providers be registered with BCBS. This registration is strictly administrative by nature, and will not allow an LLP to independently see a BCBS patient and bill direct. LLP’s may continue to see patients and bill a supervised claim under an LP, IF the LP is in the office, at the time that the services were rendered. (This is a common UNKNOWN fact)! If you are rendering supervised care and the supervising LP is NOT in the office, at the time services are being rendered, you are opening yourself and your supervisor, up to a potential audit, take back and a possible fraudulent claim investigation. Both BCBS and BCN recently published new supervision guidelines for providers to follow. They can be found on Web Denis, in the Provider Publications section.

Should you have any questions about the content of this information, please feel free to contact Cindy Moore at Health Care Connect, 734-207-5226 or email cindy@hccbilling.com. Blue Care Network and BCBS Enrollment for LLP’s