Blue Cross Blue Shield of Michigan (BCBSM) & Blue Care Network (BCN) direct reimbursement available for Licensed Professional Counselors

After years of collaborative efforts, Licensed Professional Counselors (LPCs) are now eligible to begin the BCBSM and BCN paneling process beginning October 1, 2015 and reimbursement for services rendered will begin January 1, 2016.

LPCs will have the opportunity to participate in Blue Cross Blue Shield of Michigan’s Traditional, TRUST (PPO) and Mental Health and Substance Abuse Managed Care networks (BCN). Participating LPCs will receive direct reimbursement for covered mental health services that fall within their scope of practice/licensure (which includes any service an LPC has formally/ethically received training, i.e. see MCA/MMHCA scope of practice document).

Covered mental health services will be reimbursed at 80 percent of the Traditional, TRUST and MHSAMC doctoral level practitioner fee schedule, less any member deductibles and copayments. Additional provisions for expanded coverage continue and will be made available for dissemination as they become active, i.e. reimbursement parity for doctoral level LPCs, etc.

Note: Not all BCBSM plans (i.e. Self-Funded Plans) will cover LPC services or services billed directly by an LPC. However, services may still be billed on an “incident to” basis for both LPCs and LLPCs until these plans adopt coverage for LPCs. As additional Self-Funded Plans become eligible for contract renewal, it is expected they too will adopt LPCs as covered providers under their respective plans. To find out if a subscriber has coverage, check web-DENIS for member benefits and eligibility or call PARS at 1-800-344-8525. Also, if an LPC registers as a ‘nonparticipating’ provider for Traditional BCBSM plans, payments for covered services will be sent directly to the member.

Beginning October 1, 2015, LPCs can find the Traditional, TRUST and MHSAMC practitioner agreements and enrollment forms on bcbsm.com. To find enrollment information, click on Providers, and then on Join the Blues Network and Enrollment and Changes. Specific qualification requirements are identified within each agreement. Qualified LPCs may apply for a BCBSM provider identification number by completing the enrollment applications available on this site.

Beginning February 1, 2016, LPCs (or any provider type) will not be able to enroll in BCN until the next enrollment period which is October 1, 2016 through January 31, 2017.

All interested LPCs must be registered with a National Provider Identification (NPI) number, as well as a Council for Affordable Quality Healthcare (CAQH) number. Additional information on how to obtain these numbers are available online to members of Michigan Mental Health Counselors Association (MMHCA).

For more information, contact Provider Inquiry, your BCBSM provider consultant, or MMHCA.

Thank you to all that participated in this awaited accomplishment.

Donald E. Deering, Ph.D., LPC, NCC

President, Michigan Mental Health Counselors Association

Why does MMHCA Sponsor Supervisor Training?

By James Blundo

Often I am asked, “Why does MMHCA sponsor supervisor training?” I want to take this opportunity to answer that question.

MMHCA sponsors supervisor training because we believe the role of supervisors is so important. Supervisors are the leaders of our profession in Michigan and help to shape our profession in our state. This is why it is so important that Michigan supervisors have a good understanding of our law, its history, and the unique challenges we face as Licensed Professional Counselors in Michigan. We guarantee that our MMHCA sponsored program offered by the Mentoring Institute provides this information in a way that a discounted, out-of-state program cannot.

Dr. Sara Sue Schaeffer, LPC, LMFT, ACS, one of the co-leaders of our training, served for many years as the Licensure Chair for the Michigan Counseling Association and as the first Chair of the Michigan Board of Counseling. She currently serves as Co-Chair of the MMHCA Licensure Committee along with Dr. Irene Mass Ametrano, LPC, ACS, past Co-Chair of the Michigan Board of Counseling. Dr. Schaeffer and Dr. Ametrano helped write our law, were instrumental in writing the first set of Administrative Rules to implement the law, and currently work intensely with MMHCA to protect our scope and right to practice. The MMHCA-sponsored training includes their book and DVD which are not available in any other training program.

I need to share one last important reason why your support of our supervisor training program is so critical. We currently face serious challenges to our scope of practice and ability to collect third-party reimbursement which has the potential to affect every LPC in Michigan. MMHCA is working diligently on your behalf to address these challenges. Every MMHCA member who signs up for our MMHCA-sponsored training program receives a discount on the training, and your membership in MMHCA helps us fund the efforts to defend your right to practice. In addition, we are currently offering a one-time only discount that makes this program more affordable than others.

If you are currently a LLPC Supervisor, please share this information with your colleagues who aspire to become supervisors. If you are looking for a quality supervisor training program that also supports your profession and right to practice, please sign up for our MMHCA-sponsored training program offered by The Mentoring Institute. The next program is beginning right now, but it is not too late to register.  For more information, contact Dr. Sara Sue Schaeffer at 269-327-6030.