Blue Cross Blue Shield of Michigan (BCBSM) has announced that it will begin rejecting durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) claims if the provider is not certified by the Centers for Medicare & Medicaid Services (CMS). This requirement has been included at the federal level since 2001, but has not been enforced by CMS.
Additionally, the claims processing system will soon be updated to reject claims for P&O services billed by durable medical equipment (DME) providers, and DME services billed by P&O providers. O&P providers will be required to use their provider personal identification number (PIN) to confirm their ability to bill before receiving payment for DMEPOS claims, which aligns the services rendered with the PIN. DME providers that bill for P&O services will be required to bill with a separate CMS accredited P&O PIN.
In March, according to the BCBSM announcement, it began “recredentialing” DMEPOS providers in their network by requesting submission of the CMS certification letter and a current copy of the site accreditation.
Details of the change can be found in the May issue of The Record, BCBSM’s newsletter.