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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. Blue Care Network will no longer cover select drugs under the medical benefit starting in February BCN HMOSM commercial plans will no longer cover certain medications when administered by a doctor or other health care professional under the medical benefit. This is effective Feb. 1, 2020. The medications and more information can be found on Page 35 of the January–February 2020 BCN Provider News. Take our Blues Brief survey! We want to know how satisfied you are with the Blues Brief newsletter. Please click here to take our survey. The survey closes March 31. February focus is on heart health In support of American Heart Month in February, BCN is reminding providers to screen patients for conditions that can affect heart health. BCN supports Michigan Quality Improvement Consortium guidelines, including those for screening and management of high cholesterol, high blood pressure, overweight and obesity and tobacco control. Read more on Page 17 of the January–February 2020 BCN Provider News. Reminder: e-referral upgrades coming in February Two new enhancements are coming to the e-referral system to simplify the user experience. The expected go-live date is mid-February 2020. The enhancements include:
Read more and sign up for the Learning to use the New Features of e-referral webinars on Page 44 of the January–February 2020 BCN Provider News and the January 2020 issue of The Record. Sign up for additional training webinars Provider Experience is continuing its series of training webinars for health care providers and staff. For a list of webinars, dates and times, see the February 2020 issue of The Record. Provider Training webinars posted If you missed any of our webinars or would like to revisit what was presented, webinar recordings and presentations (PDFs) can be found on web-DENIS. They are located on the BCN Provider Publications and Resources page under Learning Opportunities or the BCBSM Newsletters and Resources page under Provider Training. Additional free waiver training opportunities offered The Michigan Center for Clinical Systems Improvement, known as Mi-CCSI, and Blue Cross Blue Shield of Michigan are hosting the American Society of Addiction Medicine Treatment of Opioid Use Disorder course at various Michigan locations this year. Each course will provide the required eight educational hours to obtain the medication-assisted treatment waiver to prescribe buprenorphine in an office setting for patients with opioid use disorder. The first two sessions, both hosted by Mi-CCSI, include a financial incentive. For dates and times, see the February 2020 issue of The Record. Starting May 1, additional radiology procedures for our commercial, Medicare Plus Blue members will require prior authorization Beginning May 1, 2020, the PPO Radiology Management Program, administered by AIM Specialty Health®, will require prior authorization for additional radiology procedures. This change will apply to Blue Cross Blue Shield of Michigan commercial members, Blue Care Network commercial members and Medicare Plus BlueSM members. For procedure code details, see the February 2020 issue of The Record. Blue Cross and seven health organizations will share financial risk for patient care and health Blue Cross Blue Shield of Michigan and seven health organizations have agreed to a next-generation value-based incentive agreement as part of our Blueprint for Affordability. The organizations are:
For more information about this new payment model, see the January 2020 issue of The Record. HEDIS medical record reviews begin Blue Cross and BCN are conducting Healthcare Effectiveness Data and Information Set, or HEDIS®,* medical record reviews for members who live in Michigan from January through May. Blue Cross and BCN team members will conduct HEDIS reviews for members who had services in 2019. For more details about HEDIS reviews, see Page 15 of the January–February 2020 BCN Provider News or the February 2020 issue of The Record. *HEDIS is a registered trademark of the National Committee for Quality Assurance. New tools available We’ve updated the following resources to assist you with your Blue Cross and BCN patients:
The 2020 products at a glance, Understanding member ID cards and Finding your plans and networks flyers can be found on web-DENIS in the BCN Provider Publications and Resources page under BCN Products or the BCBSM Newsletters and Resources page under Products and Networks. The Keep office information secure flyer can be found on ereferrals.bcbsm.com under Quick Guides. |
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. |