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Billing News :: Blue Care Network MyBlue Medigap Update

MyBlue Medigap is a new Blue Care Network Medicare supplement product. Health care providers began seeing members who have MyBlue Medigap coverage beginning Dec. 1, 2009. Although members carry a BCN ID card, they can receive services from any provider who accepts Medicare. This includes BCBSM providers not contracted with BCN.

While MyBlue Medigap is a BCN product, it is not an HMO product. There is no physician network, there are no referral or authorization requirements, and members do not select a primary care physician.

At the time of service, a member will present two ID cards: a BCN MyBlue Medigap card with an XYJ prefix and the familiar red, white and blue Original Medicare card. At every visit, health care providers should check web-DENIS to confirm the member has coverage. When verifying the member’s eligibility, select Blue Care Network as the line of business, not BCBSM or Medicare Supplemental since the latter contains only BCBSM Medicare supplemental member information.

Medicare is the primary carrier for all MyBlue Medigap members and must be billed first. Medicare then automatically forwards claims to BCN for payment. MyBlue Medigap claims follow the billing guidelines described in the BCN Provider Manual Claims chapter. If you expect payment from BCN and have not received it within 30 days of the Medicare payment, submit a copy of the claim to BCN with the Medicare explanation of benefits statement attached.

Billing News :: Time Filing Limit for Master Medical Claims Announced

Effective May 1, 2010, for groups that have the Master Medical benefit, BCBSM will only pay for Master Medical claims that are filed within two years from the date of service.