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Provider Engagement Exchange (PEX) Program for Out-of-State Medicare Advantage Preferred Provider Organization (PPO) Members Update

The Blue Cross Blue Shield Association (BCBSA), an association of Blue Cross Blue Shield® Plans, enters their third year of this project. Their approach is to assist with care management for out-of-area group Medicare Advantage members. Out-of-state Medicare Advantage Blue plans will engage Blue Cross Blue Shield of North Dakota (BCBSND) to connect with our providers to close care gaps and request medical records as needed for their members living in our service area. BCBSND will contact you via letter or email about these requests.

Currently, our engagement request numbers have grown in the past six months, but we remind providers of the importance and benefits of this program for your patients. Responding to the engagement letter or medical record request promptly is important. This arrangement continues to enhance the way Blue plans support Medicare Advantage group members who live outside their designated service area.

Thank you for supporting this program's continued support for the Medicare population of North Dakota.