Payer Updates | October 2025

For a curated summary of the latest payer updates* impacting Northern Michigan provider offices, grouped by payer then category, please see below:

BCBSM and BCN

All Providers: BCBSM and BCN are replacing their e-referrals application with a new platform for authorizations. SOURCE

All Providers: BCBSM continues to experience longer claims processing times due to the NASCO operating system transition. SOURCE

Priority Health

All Providers: Priority Health has updated their resource for drug coverage review. Feedback back is requested on Priority Health’s new drug list format by emailing ph-pharmacybusinessopswebsite@priorityhealth.com.

*News items from the following payers were reviewed for this month’s highlighted articles: Aetna, BCBSM, Blue Care Complete, Blue Care Network (BCN), Health Alliance, McLaren, Molina, and Priority Health.