Blues Brief - For physician offices

Download a printable version to read or shareDecember 2019

This newsletter includes short summaries, reminders and updates for Blue Cross and BCN providers. Please visit The Record or BCN Provider News for complete newsletter editions.


2020 products at a glance flyers available

These flyers are general summaries of Blue Cross Blue Shield of Michigan and Blue Care Network products, including the product name, prefix and brief description. These flyers can be found on the BCN Provider Publications and Resources web-DENIS page under BCN Products or the BCBSM Newsletters and Resources web-DENIS page under Products and Networks.


How to confirm the networks with which you participate

We have a document that helps providers find the Blue Cross and BCN products with which they participate. Finding your plans and networks shows you how to use the online provider search to confirm which products you accept. When new patients present themselves or current patients change health plans, you’ll know if you accept the plan they have. To find the document, see Page 2 of the May–June 2019 BCN Provider News.


Health e-BlueSM data entry due soon

The deadline for entering data in Health e-Blue for 2019 treatment opportunities is midnight, Jan. 25, 2020. Data entered after this deadline will not count for 2019 incentives. The deadline for submitting electronic medical record files is Feb. 7, 2020.


New resources for your practice

We’ve put together some resources to help you engage members with your practice’s patient portal, as well as our online member account tools. You can learn about the Patient Digital Engagement Toolkit, webinar and tips to improve patient portal usage in the November 2019 issue of The Record or on Page 7 of the January-February 2020 issue of BCN Provider News.

Summary of upcoming changes effective Jan. 1, 2020

Blue Cross and BCN to cover select hyaluronic acid products

See the November 2019 issue of The Record and on Page 36 of the January-February 2020 issue of BCN Provider News.


Inpatient acute care admissions could be subject to clinical review

PPO

See the upcoming January 2020 issue of The Record.


BCN commercial members are moving to exclusive specialty pharmacy network

HMO

See Page 32 of the September–October 2019 BCN Provider News.


We’ll cover hemophilia drugs under the pharmacy benefit

HMOPPO

See Page 25 of the November–December 2019 BCN Provider News or the October 2019 issue of The Record.


Commercial PPO members will need authorization for Eylea and Lucentis

PPO

See the December 2019 issue of The Record.


Direct reimbursement available to clinical nurse specialists

See Page 3 of the November–December 2019 BCN Provider News or the October 2019 issue of The Record.


New Ascension Genesys plan option: GM ConnectedCare

PPO

See the December 2019 issue of The Record.


Oncology management program for Medicare Advantage plans

MA HMO MA PPO

See Page 9 of the November–December 2019 BCN Provider News or the November 2019 issue of The Record.


Consider an ASC as site of care option for low-risk patients

MA HMO MA PPO

See the upcoming January 2020 issue of The Record.

 

Tell us how satisfied you are with our Utilization Management services – survey now open

Blue Cross and BCN want to know how satisfied you are with our Utilization Management services. Let us know by completing a short survey at tinyurl.com/y5ukrfr9. The survey closes Dec. 31, 2019. Encourage your office colleagues, including physicians, nurses and referral coordinators, to take the survey as well so we can improve our processes to better support you as you care for our members.


Board-certified behavior analysts will need to be licensed to be eligible for reimbursement

Starting Jan. 7, 2020, board-certified behavior analysts practicing in Michigan must be licensed by the State of Michigan to be eligible for reimbursement from Blue Cross and BCN. BCAs who aren’t licensed aren’t eligible for reimbursement for services provided on or after Jan. 7, 2020. For more information, see Page 23 of the September–October 2019 BCN Provider News or the September 2019 issue of The Record.


We’re using some new codes for online visits, starting Jan. 1

PPO

Effective Dec. 31, 2019, procedure codes *98969 and *99444 will no longer be payable for an online visit.

Starting Jan. 1, 2020, physicians must submit their claims using one of these new patient-initiated, digital-communication codes: *99421, *99422 or *99423. For services provided by a nonphysician, use code *98970, *98971 or *98972.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2018 American Medical Association. All rights reserved.


Blue Cross, BCN to support providers who offer comprehensive opioid treatment

Starting Jan. 1, 2020, Blue Cross and BCN will use bundled rates to reimburse providers who offer certified opioid treatment programs, or OTPs. The bundled payment includes both drug and non-drug components and may allow for intensity add-on codes to be used when needed. For more details, see the December 2019 issue of The Record or on Page 24 of the January-February 2020 issue of BCN Provider News.


Free waiver training to provide medication-assisted treatment

The Michigan Center for Clinical Systems Improvement, known as Mi-CCSI, is hosting the American Society of Addiction Medicine Treatment of Opioid Use Disorder course at three locations in Michigan in 2020. The first 15 providers attending the full eight hours will be paid for the day. For more details or to register for the course, see the December 2019 issue of The Record or on Page 19 of the January-February 2020 issue of BCN Provider News.


Holiday office closings

Blue Cross and BCN offices will be closed Dec. 24 through 25 (Christmas) and Dec. 31 through Jan. 1.

Article Key

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2018 American Medical Association.
All rights reserved.


Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.