Medicare AdvantageDocumentationHigh impact
Expansion of medical record requests to include Medicare Plus Blue claims
BCBS Michigan·MI·Medical Policy
Effective date
Jun 1, 2026
We identified it
Jun 16, 2026
Summary
Starting June 2026, Blue Cross Blue Shield of Michigan will expand medical record reviews to include Medicare Plus Blue PPO claims. Claims selected for review will be initially denied and require submission of supporting medical records before payment is issued.
Action Required
Before June 1, 2026: Billing team must prepare workflows to respond to medical record requests for Medicare Plus Blue PPO claims. When claims are denied for record review, submit supporting documentation promptly to receive payment. Train staff on new documentation submission process similar to existing BCBSM commercial review procedures.