> ## Documentation Index
> Fetch the complete documentation index at: https://docs.thrizer.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Register with BCBS of Michigan out of network

> Find Michigan's mental-health practitioner enrollment form and select Traditional-Nonparticipating without changing reimbursement to the client.

## Before you start

Use this guide when BCBS of Michigan is a required Local / Host Plan for your practice or claim-service location. Your practice coordinates registration and any required clinician records so the payer can process affected claims. Registration is separate from joining a network and does not guarantee reimbursement.

Not sure which plan applies? First [identify your required Local / Host Plan](/help/claims/bcbs-reimbursement-and-registration#find-and-register-with-your-local-/-host-plan).

These steps concern **mental-health practitioner enrollment** with BCBS of Michigan. Use the clinician's actual license type and practice arrangement when answering the enrollment selector.

## Registration steps

<Steps>
  <Step title="Find the form for your clinician">
    Open [Enroll or make changes](https://www.bcbsm.com/providers/network/enroll/). Select **Physicians and Professionals**, then **Enroll a new provider**, and choose the clinician's provider type.

    Answer the incorporation and existing-group questions for your actual practice. A solo clinician's answers are not the defaults for a group practice.
  </Step>

  <Step title="Choose nonparticipating enrollment">
    Download **New Mental Health Practitioner Enrollment Form** from the forms list. In **Section 4 — Requested Networks**, choose **Traditional-Nonparticipating** for this route. Do not select participating, PPO, BCN, or Medicare Advantage networks simply to establish an out-of-network record.
  </Step>

  <Step title="Complete the applicable information">
    Enter the clinician and practice information and follow the form's documentation requirements. Complete it electronically rather than handwriting it.

    If you are establishing a group or affiliating a clinician with one, confirm the required group forms with Michigan. New solo practices and new groups should not assume the existing-group self-service tool can establish their initial records.
  </Step>

  <Step title="Review the signature terms and send">
    Have the authorized person review the [current form](https://www.bcbsm.com/amslibs/content/dam/public/providers/documents/enrollment/WF-10575.pdf), including its nonparticipating signature terms. Fax the completed application to **1-866-900-0250**, separately for each provider, as instructed. Keep a copy and confirm the active record and required group affiliation.

    For enrollment questions, call **1-800-822-2761**.
  </Step>
</Steps>

## Payment terms on the form

For BCBS claims through Thrizer, your client pays the full session fee and receives any insurance reimbursement. Do not elect payment to the clinician for this process.

The form includes conditions for providers who accept assignment, participate on a claim, or elect direct BCBSM payment. Those conditional provisions should not be assumed to apply automatically to member reimbursement. If a required selection appears to direct payment to your practice, ask Michigan how to complete nonparticipating enrollment for member reimbursement **before signing**.

## What happens next

Once each required plan confirms registration and the required clinician associations are active, [notify Thrizer support and review what happens next](/help/claims/bcbs-reimbursement-and-registration#registration-confirmed-next-steps).

For associate, pre-licensed, or supervised clinicians, confirm payer recognition separately and review [Thrizer's supported claim structure](/help/claims/bcbs-reimbursement-and-registration#associate-pre-licensed-or-supervised-clinicians).