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  • Qualification Form Instructions - Bcbsm.com

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Qualification Form Instructions Congratulations on taking steps toward maintaining or improving your health! The Blue Cross Blue Shield of Michigan Qualification Form is enclosed for you and your physician.

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All claims must be resolved with 365 calendar days from the date of service or discharge date. This applies to capitated and fee-for-service claims. Please allow for normal processing time before re-submitting a claim either through the EDI or paper process.

Appeals must be submitted within 180 days of the date on the original remittance advice with the original clinical editing denial on it. If the appeal is not received within that time frame, it will not be accepted and you will not have another opportunity to appeal.

Contact your practice management or hospital information system for instructions on how to receive ERAs from Blue Cross Complete under Payer ID 32002 and the ECHO Payer ID 58379.

All claims must be submitted within 180 days of the date of service. When the required information is not included, the claim will be denied. A new claim with correct and complete information must be submitted in order for a denied claim to be reconsidered.

Blue Care Network of Michigan is a nonprofit health maintenance organization. We're owned by Blue Cross Blue Shield of Michigan.

To submit electronic claims for Blue Cross' Medicare Advantage members through a clearinghouse or directly to DentaQuest through our Trading Partner Portal, you must use payer ID: BBMDQ.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232