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

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 reach out to you via letter or email regarding the details of these requests.

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

At this time, these requests do not include the new NextBlue of North Dakota Medicare Advantage plan, which began January 1, 2021.