Wiki Fee Schedule for BCBS

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schanderson

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Good day,

I am currently in the state of Michigan and BCBS has gone to Availity as the source to check on things, but it is not an easy site to find things. I have tried a few ways to try to get the new fee schedule for July of 2023, but it pulls up old articles from Blue Cross News. The website that they do have left for providers to tell you to call them about claims, but it is not claims. Where did they hide it?

Sincerely,

Finding the needle in the haystack
 
schanderson said:
Good day,

I am currently in the state of Michigan and BCBS has gone to Availity as the source to check on things, but it is not an easy site to find things. I have tried a few ways to try to get the new fee schedule for July of 2023, but it pulls up old articles from Blue Cross News. The website that they do have left for providers to tell you to call them about claims, but it is not claims. Where did they hide it?

Sincerely,

Finding the needle in the haystack
Click to expand...

The contracting rep or provider rep should be able to get you a copy of your contracted fee schedule.
 
I access our Anthem (our local BCBS) fee schedule in Availity through Claims & Payments > Fee Scheduling Listing > Additional Fee Schedules and it's listed there. Alternatively, I can go to Payer Spaces > Anthem Ohio and Fee Schedule is one of the options under Applications. I agree with Susan about going to your rep for the fee schedule as well but frankly, it's easier to do it myself most of the time.

if you haven't already done so, you may want to check your permissions to ensure you were granted access to view the fee schedule.
 
schanderson said:
Good day,

I am currently in the state of Michigan and BCBS has gone to Availity as the source to check on things, but it is not an easy site to find things. I have tried a few ways to try to get the new fee schedule for July of 2023, but it pulls up old articles from Blue Cross News. The website that they do have left for providers to tell you to call them about claims, but it is not claims. Where did they hide it?

Sincerely,

Finding the needle in the haystack
Click to expand...
They do a good job of burying stuff on Availity. The way I have always found mine in Availity is under "Payer Spaces">Regence BCBS of OR; then click the "Resources" tab; then filter by "Reimbursement Schedules". A link will be listed that says "Supplemental information-Commercial Reimbursement Schedule". It's not really the actual fee schedule but you can look up your allowables using your contract rates. I never noticed there is actually an app for "Fee Schedule Listing" under Claims & Payments. Good to know! Thanks trarut!!
 
trarut said:
I access our Anthem (our local BCBS) fee schedule in Availity through Claims & Payments > Fee Scheduling Listing > Additional Fee Schedules and it's listed there. Alternatively, I can go to Payer Spaces > Anthem Ohio and Fee Schedule is one of the options under Applications. I agree with Susan about going to your rep for the fee schedule as well but frankly, it's easier to do it myself most of the time.

if you haven't already done so, you may want to check your permissions to ensure you were granted access to view the fee schedule.
Click to expand...
I have gone the way that you state but it only shows max fee schedule no fee schedule for BCBSM
 
That's unfortunate. Are you the Availity administrator to be able to check your permissions? Are you certain that BCBSM has published the fee schedule on Availity? If it's a recent switch, they may not have it available yet. It probably won't help but I found this information on an FAQ from last year:

Blue Cross fee schedule information is available within Availity. Here’s how to find it:
1. Click Payer Spaces on the Availity menu bar.
2. Click the BCBSM and BCN logo.
3. Click Secure Provider Resources (Blue Cross and BCN) on the Resources tab.
4. Click Fee Schedules.

It sounds like you may need to contact Availity directly to see if they can help.
 
trarut said:
That's unfortunate. Are you the Availity administrator to be able to check your permissions? Are you certain that BCBSM has published the fee schedule on Availity? If it's a recent switch, they may not have it available yet. It probably won't help but I found this information on an FAQ from last year:

Blue Cross fee schedule information is available within Availity. Here’s how to find it:
1. Click Payer Spaces on the Availity menu bar.
2. Click the BCBSM and BCN logo.
3. Click Secure Provider Resources (Blue Cross and BCN) on the Resources tab.
4. Click Fee Schedules.

It sounds like you may need to contact Availity directly to see if they can help.
Click to expand...
Thank you this worked for me!
 
Hey there! I am also having issues pulling our fee schedule. We are in Colorado and when we go to the fee schedule page it asks us to pick a network and then enter a License Prefix and Number. We have tried multiple providers and nothing seems to work. Any insight on that issue? When we ask our rep we are directed to Availity, when brought up to them we are directed back to our rep. TIA
 
massmtngirl said:
Hey there! I am also having issues pulling our fee schedule. We are in Colorado and when we go to the fee schedule page it asks us to pick a network and then enter a License Prefix and Number. We have tried multiple providers and nothing seems to work. Any insight on that issue? When we ask our rep we are directed to Availity, when brought up to them we are directed back to our rep. TIA
Click to expand...
Hmm, we have to select a network but not a license prefix. We have a couple of payers that won't give fee schedule info without a patient identifier for that network. Are you sure the field is for a provider license prefix and not a patient prefix and ID number? If it's a provider license prefix, then I'm stumped. Sorry!
 
trarut said:
Hmm, we have to select a network but not a license prefix. We have a couple of payers that won't give fee schedule info without a patient identifier for that network. Are you sure the field is for a provider license prefix and not a patient prefix and ID number? If it's a provider license prefix, then I'm stumped. Sorry!
Click to expand...
So we have tried selecting different networks and it all pulls the same. While it says the license prefix/number is optional, when we try submitting it without one we get the red error message noted in the attached photo.
 

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Yep, that's new to me. Have you hovered over the help icon next to those field names? A couple of things I would try in your shoes:
  • Colorado state medical licenses are formatted XX.000000 - have you tried enter the alpha portion as the prefix and the numeric as the license number? It's a long shot but worth a try.
  • Contact the person who handles the provider credentialing to ask if they have the provider license prefix and number.
This is definitely a BCBS problem and you'll have to contact someone at BCBS of Colorado that can help you. Availity won't have this information.

I wish I could help and hope you find a solution!
 
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