MPTA's Payment Committee is continually meeting with health care professionals and various insurance companies throughout the state of Michigan to keep our members notified of any changes coming and to advocate for our physical therapy professionals. As a benefit to our membership, MPTA members are notified immediately of any policy changes or deadlines to an insurance plan or group.
Not all Payment questions can be treated the same way. Please email email@example.com if you have a specific question as it relates to Payment.
The MPTA Patient Advocacy Action Center Portal is now available!posted: February 07, 2017
The MPTA Patient Action Center portal is now available! This portal will allow patients to quickly and easily write letters to BCBSM about their negative experiences. CLICK HERE to access the portal.
If your patients experience delays or other barriers to necessary care because of eviCore, they should be encouraged to call the number on the back of their ID card. If the BCBSM Customer Service Representative determines it is a complaint/grievance, they will forward it according to BCBSM procedures.
You should also encourage them to access the MPTA Patient Advocacy Action Center portal. This will allow patients to use a template letter or customize their own letter, and will allow us to track the scope and extent of the problem. BCBSM may follow-up with patients about their experiences, so please prepare them for that possibility and encourage them to freely share their frustrations.
MPTA is especially concerned about the potential for errant determinations of medical necessity by eviCore, who is required to ensure their determination is consistent with general Medicare standards. According to BCBSM: “If at any time there is a dispute with the meeting of medical necessary, the provider can always request an appeal; for pre-auth the appeal goes to the MA PPO area for appeals at BCBSM and will be reviewed in full.” Please email firstname.lastname@example.org to let us know how frequently you are using this appeals process and whether you feel it is timely and effective.
Please also contact MPTA if you are experiencing problems with your Provider Category (A, B, or C). We have heard from members who have been mis-categorized and are being subject to unnecessary procedures with eviCore.
Important Payment Resources
- MPTA-BCBSM Meeting October 23 - Summary and Related Activities [Login]
- Code of Federal Regulations
- State of Michigan:
- APTA Resources: