CareCentrix HIPPS Questionnaire updates targeted for April for Medicare Plus Blue^SM members who receive home health services in Michigan

Since CareCentrix^® began managing authorizations for Blue Cross Blue Shield of Michigan and Blue Care Network Medicare Advantage members in June 2021, you've been using the CareCentrix questionnaire to generate unique Health Insurance Prospective Payment System, or HIPPS, codes for Medicare Plus Blue^SM members who receive services in Michigan.

Based on feedback from home health agencies, Blue Cross, BCN and CareCentrix are working to:

• Remove the HIPPS questionnaire from the HomeBridge^® portal
• Accept HIPPS codes generated by home health agencies

These changes are targeted for April 2022.

In the meantime, CareCentrix has published information about completing the HIPPS questionnaire* to help home health care agencies as they complete HIPPS questionnaires.

Note: This change will affect only Medicare Plus Blue members who receive services in Michigan. It won’t affect Medicare Plus Blue members who receive services outside of Michigan or BCN ^SM members.

Reminders

• If you don't have the information necessary to generate a HIPPS code when entering a prior authorization request, call CareCentrix at 1-833-409-1280 when you have the necessary information and before submitting the claim.
• If you haven't provided a HIPPS code to CareCentrix by day 25 of an episode of care, CareCentrix will contact you to obtain the HIPPS code. If you don’t have a HIPPS code at this point, CareCentrix can generate one for you using the Outcome and Assessment Information Set, or OASIS, assessment.
• If needed, CareCentrix will contact you to update the HIPPS code based on their review. You can also contact CareCentrix at 1-833-409-1280 to correct HIPPS codes.
• When submitting claims for home health services provided to Medicare Plus Blue members in Michigan, the HIPPS code on the claim that you submit to Blue Cross for payment must match the HIPPS code on the authorization.
• For more information about the program, see the document titled Home health care: Frequently asked questions for providers (PDF).

CareCentrix is an independent company that manages the authorization of home health care services for Blue Cross Blue Shield of Michigan and Blue Care Network members who have Medicare Advantage plans.

*Clicking this link means that you’re leaving the Blue Cross Blue Shield of Michigan and Blue Care Network website. While we recommend this site, we’re not responsible for its content.

Posted: February 2022
Line of business: Blue Cross Blue Shield of Michigan