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STATE OF MICHIGAN DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS OFFICE OF FINANCIAL AND INSURANCE REGULATION Before the Commissioner of Financial and Insurance Regulation In the matter of XXXIX Petitioner

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What is bcn 121724 out-of-network services?

bcn 121724 out-of-network services refers to a form used to report services provided by healthcare providers who are not in the preferred network of BCN (Blue Care Network) insurance. It is used to claim reimbursement for these out-of-network services.

Who is required to file bcn 121724 out-of-network services?

Healthcare providers who have provided services to BCN members that are outside of BCN's preferred network are required to file bcn 121724 out-of-network services in order to claim reimbursement.

How to fill out bcn 121724 out-of-network services?

To fill out bcn 121724 out-of-network services, healthcare providers need to provide information such as patient details, the services provided, dates of service, charges, and any supporting documentation. The form should be completed accurately and submitted with all the required information.

What is the purpose of bcn 121724 out-of-network services?

The purpose of bcn 121724 out-of-network services is to enable healthcare providers to report and claim reimbursement for services provided to BCN members that are outside of BCN's preferred network. It helps ensure that providers receive payment for these out-of-network services.

What information must be reported on bcn 121724 out-of-network services?

On bcn 121724 out-of-network services, healthcare providers need to report information such as patient demographics, provider information, dates of service, billed charges, CPT codes for the services provided, and any supporting documentation.

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