Additional Announcements

*Access to Health Focus*

In order to access Health Focus please fill in and return this form.  Health Focus Log In Form

*BCBSM Updates*

Reminder: Commercial PPO Blueprint Funding Allocation to start 7/1/2023

In order to fund the Commercial PPO Blueprint risk pool, Blue Cross will introduce a 1.5% risk allocation for Commercial PPO professional fees. The 1.5% risk funding allocation will begin July 1, 2023 and will be off-set by an overall professional fee schedule increase of 1.5%. Please make your billers aware of the professional fee schedule increase of 1.5% see below article for details:

https://www.bcbsm.com/content/dam/microsites/corpcomm/provider/the_record/2023/apr/Record_0423j.shtml 

*MDHHS Announcement*

Michigan’s new Prior Authorization (PA) law, signed into law last year by Governor Gretchen Whitmer, took effect June 1, 2023. The new law includes a requirement for health insurers and health care providers to review and submit PAs online, faster PA processing timelines, and new peer review and clinical validity requirements. The law also puts in place new transparency requirements, including a requirement for health insurers to notify contracted health care providers of any new or amended PA requirement or restriction prior to the requirement or restriction taking effect. These changes only apply to commercial insurance policies regulated by the Michigan Department of Insurance and Financial Services (DIFS), and do not affect Medicaid, Medicare, Medicare Advantage, or self-funded health plans. For more information about the new law, visit the DIFS’ Prior Authorization FAQ page.

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*Priority Health Announcement*

Verify your providers’ information with BetterDoctor, NPPES 

In the coming weeks, your provider offices can expect to hear from BetterDoctor as they work to verify the provider information in Find A Doc, our online provider directory. This quarterly outreach process will be familiar to many of your providers because we do this today with another vendor. Learn more about BetterDoctor. 

What if the information BetterDoctor shares is wrong? 

Provider offices should submit updates for any incorrect information through prism. Or if your organization has a delegated arrangement with us, make changes through your existing process. Find more information on reporting provider changes. 

Don’t forget to check NPPES 

Don’t forget to review your providers’ National Provider Identifier (NPI) data in the National Plan & Provider Enumeration System (NPPES) as soon as possible. Providers are legally required to keep their NPPES data current, updating information within 30 days of a change. Here are a few tips for your NPPES update. 

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• ACO REACH - Participation Agreement

• Abbott Infant Formula Recall Update from Michigan WIC: click for recall information

• Coronavirus (COVID-19) Updates

  • Please sign in and look under each health plan for specific, plan-related information

  • CMS Covid Resources and MDHHS Vaccine Resources

  • Michigan COVID-19 Testing Sites

  • BCBSM COVID VACCINE UPDATES April 2023**

Get a Flu Shot!! Patients can call or visit:

Valerie Borntrager at Dr. Kostecke M.D. P.C.

Office- (248)676-0991

Fax- (248)676-9862

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