BCBS Michigan to charge hospitals for repeated claims denial appeals
By Admin | February 19, 2025
Blue Cross Blue Shield of Michigan will begin enforcing a long-standing policy that would charge hospitals that repeatedly appeal denied claims.
Although the policy has been part of the company’s commercial PPO hospital agreements for years, it has not been enforced, the insurer told Becker's. The policy will apply to all in-network hospitals in Michigan, starting March 1.
Under the new enforcement, when an in-network hospital disagrees with Blue Cross’ reimbursement decision regarding the medical necessity of services, the hospital can request an external review by a panel of practicing physicians. If the review supports Blue Cross’ decision, the hospital will be...(More)
For more info please read, BCBS Michigan to charge hospitals for repeated claims denial appeals, Becker's Payer Issues
