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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.
Using telehealth to help close patient gaps in care We’ve recently created the Telehealth Summary of 2020 HEDIS® Measures* document, which summarizes how you can use telehealth for prevention and screening, care coordination, diabetes care and services for cardiovascular, respiratory, musculoskeletal and behavioral health conditions, among others. To find the document, log in as a provider at bcbsm.com and follow this path: BCBSM Provider Publications and Resources/Newsletters & Resources/Clinical Quality Corner. For more information, including a list of additional resources, see the October 2020 issue of The Record or the upcoming issue of the November–December 2020 BCN Provider News. *HEDIS, which stands for Healthcare Effectiveness Data and Information Set, is a registered trademark of the National Committee for Quality Assurance. We’ve changed preventive screenings to a calendar year schedule We’ve changed the frequency for preventive screenings to a calendar year for BCN HMO℠ members. We're doing this to align with Blue Cross PPO plans and allow members who have deferred their screenings due to COVID-19 to have more flexibility in future scheduling. This means members can schedule their routine screenings at any time during the year regardless of when they had the screening in the previous year. For more information, see Page 1 of the September–October 2020 BCN Provider News. New secure provider website coming in 2021 We’re introducing a new secure provider website in 2021 with additional online tools and functionality designed to make it easier for you to do business with us. The new site, operated by Availity, will still provide access to many of the tools you currently use, but it will have a simple, fresh look, updated search features and improved performance. For more information, see Page 1 of the September–October 2020 BCN Provider News or the September 2020 issue of The Record. Reminder: Influenza testing now covered in doctor’s office The following four CPT codes for influenza tests can now be performed in a physician’s office to help physicians rule out influenza during the COVID-19 pandemic: *87275, *87276, *87400 and *87804. For more information, see the October 2020 issue of The Record or the upcoming issue of the November–December 2020 BCN Provider News. *CPT codes, descriptions and two-digit numeric modifiers only are copyright 2019 American Medical Association. All rights reserved. We are simplifying the inquiry and appeal process Blue Cross will begin accepting your post-service claim appeal requests verbally when you contact Provider Inquiry, effective Oct. 1, 2020. You should continue to contact Provider Inquiry for any inquiry related to benefits, eligibility and claims. For medical providers: 1-800-344-8525 Note: These changes only apply to commercial PPO appeals. BCN HMO, BCN Advantage℠, Medicare Plus Blue℠ PPO, Medicare Private Fee for Service, Federal Employee Program® and Blue Cross Complete plans, as well as prior authorization and clinical editing appeals, are not impacted by these changes. For more information, see the September 2020 issue of The Record. Incentives and training offered to expand use of CoCM Blue Cross is expanding its use of the Collaborative Care Model, a method of integrating behavioral health within a primary care setting, with participating practices to better meet the needs of patients who have behavioral health conditions. Our Physician Group Incentive Program has developed incentives for learning about and using the model. Practices that are interested in learning more about training and incentive opportunities available are encouraged to contact their physician organizations. For more information, see the October 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. The webinars are designed to help you work more efficiently with Blue Cross and BCN. Our next webinar, Blue Cross 201 – Claims Troubleshooting, starts Nov. 5. The Blue Cross 201 webinar provides an in-depth learning opportunity and builds on information shared in our Blue Cross 101: Understanding the Basics webinar. This session reviews the processes and tools available when resolving common issues with claims. See the October 2020 issue of The Record to register. Other on-demand training webinar recordings are available on web-DENIS. Read more on Page 7 of the September–October 2020 BCN Provider News. National Prescription Drug Take Back Day scheduled for Oct. 24 Let patients know the next National Prescription Drug Take Back Day is scheduled for Oct. 24 from 10 a.m. to 2 p.m. These twice-yearly events, coordinated by the U.S. Drug Enforcement Administration, provide a safe, convenient and responsible means of disposing of prescription drugs, while also educating the public about the potential for abuse of medications. For more information, see the October 2020 issue of The Record. Remind your eligible patients to get mammograms every two years October is Breast Cancer Awareness Month. One in eight women in the United States will be diagnosed with breast cancer in her lifetime, making it the second most common cancer in women. You play an integral role in early detection by recommending regular screenings to your patients. For more information, including a HEDIS® Breast Cancer Screening tip sheet, see Page 20 of the September–October 2020 BCN Provider News. HEDIS, which stands for Healthcare Effectiveness Data and Information Set, is a registered trademark of the National Committee for Quality Assurance. | |
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