Download a printable version to read or shareSeptember 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.|
We’re making some changes to increase security on Provider Secured Services
Your online security is important to us, so we’re making some changes to Provider Secured Services to help make your information and transactions more secure.
The following changes will go into effect Sept. 12:
For more details, see the Page 1 of the September-October 2019 BCN Provider News or the September 2019 issue of The Record.
Make sure to download and use the most recent forms
To avoid returned forms or delays in processing, use the latest forms found on bcbsm.com or web-DENIS. Download the necessary forms to ensure you’re always completing the most up-to-date versions. We recommend not storing copies of our forms.
List top locations when updating your information with CAQH
Blue Cross Blue Shield of Michigan and Blue Care Network have updated our systems in collaboration with CAQH that allows providers to list the active locations where you see members.
For more details, see the Page 3 of the September–October 2019 BCN Provider News.
How can we improve our online tools?
Blue Cross and BCN want to know what we can do to improve our online tools to make them easier and more useful for you — our partner providers. We specifically want to know about your experience using online provider tools and services, including the tools available when you log in to our secure provider website at bcbsm.com. The survey can be found on Page 4 of the September–October 2019 BCN Provider News.
Sign up for additional training webinars
We’re continuing our series of training webinars for health care providers and staff. The webinars are designed to help you work more efficiently with Blue Cross and BCN. To find out more and register, see Page 4 of the September–October 2019 BCN Provider News or the September 2019 issue of The Record.
Holiday office closings
Blue Cross and BCN offices will be closed on Sept. 2 for Labor Day.
New advanced illness and frailty exclusions for HEDIS star measures
The National Committee for Quality Assurance now allows providers to exclude patients from select Medicare Star Rating System measures that are also HEDIS® measures* due to advanced illness and frailty. NCQA acknowledges that some measured services won’t benefit patients who are in declining health.
For a description of the criteria and a list of HEDISapproved billing codes, view the 2019 HEDIS Advanced Illness and Frailty Exclusions Guide in the September 2019 issue of The Record.
*HEDIS, which stands for Healthcare Effectiveness Data and Information Set, is a registered trademark of the National Committee for Quality Assurance.
Oncology management program for MA plans begins in January
A new utilization management program for medical oncology for Medicare Plus BlueSM PPO and BCN AdvantageSM members will begin in January 2020. Providers will need to obtain authorizations from AIM Specialty Health® for certain medical oncology and supportive care medications.
To learn more and for the dates of upcoming webinars, see Page 10 of the September-October 2019 BCN Provider News or the September 2019 issue of The Record.
2019 IVIG dosing strategy is changing, starting Oct. 1
Blue Cross and BCN currently include immune globulin products in the prior authorization program under pharmacy and medical benefits for commercial members. Intravenous and subcutaneous immune globulin products available for the medical benefit are also included in the site of care program.
To minimize drug waste, reduce unnecessary drug exposure and decrease the risk of adverse events, we will update our dosing strategy for intravenous and subcutaneous immune globulin therapy. Effective Oct. 1, 2019, we’ll calculate doses using adjusted body weight for members who meet specific criteria. Read more on Page 30 of the September–October 2019 BCN Provider News or the August 2019 issue of The Record.
Board-certified behavior analysts will need to be licensed to be eligible for reimbursement
Starting Jan. 1, 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. Board-certified behavior analysts who aren’t licensed aren’t eligible for reimbursement for services provided on or after Jan. 1, 2020.
For more information, see Page 23 of the September–October 2019 BCN Provider News or the September 2019 issue of The Record.
Update your Provider Authorization form when changes occur
Blue Cross and BCN are dedicated to safeguarding the protected health information of our members. These safeguards include the completion of a Trading Partner Agreement and Provider Authorization form as part of the electronic data interchange setup process. All EDI trading partners must complete a TPA and Provider Authorization form before exchanging any PHI with Blue Cross. For more details, see Page 5 of the September–October 2019 BCN Provider News or the April 2019 issue of The Record.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.