ROU

BCBS Prefix ROU

Blue Cross and Blue Shield of Michigan

Michigan • POS, High-Deductible Health Plan (HDHP), EPO

Billing essentials

Provider phone
(800) 344-8525
Electronic payer ID
SB711
Claims mailing address
P.O. Box 312500, Detroit, MI 48231-2500
Timely filing limit
365 daysCompare all plans
Prior authorization phone
(800) 344-8525
Provider website
https://www.bcbsm.com

Coverage under prefix ROU

POS

This is a Point of Service (POS) prefix. POS plans offer flexibility similar to a PPO but incentivize in-network care through lower cost-sharing. Members designate a primary care physician who can issue referrals for the highest level of benefits. Out-of-network claims are covered but at significantly reduced rates.

HDHP

This prefix is associated with a High-Deductible Health Plan. HDHP members pay more out-of-pocket before insurance coverage begins. These plans are commonly paired with HSA or HRA accounts. When billing, be aware that the member may have significant cost-sharing responsibility until their annual deductible is satisfied.

EPO

EPO coverage under this prefix means the member must use network providers but does not need referrals for specialist visits. This plan type is becoming more common as it offers lower premiums than PPO plans while providing more flexibility than HMOs. Verify network status before providing services.

About Blue Cross and Blue Shield of Michigan

Independent licensee of the Blue Cross Blue Shield Association serving Michigan.