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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 Cross and BCN covering additional vaccines To increase access to vaccines and decrease the risk of vaccine-preventable disease outbreaks, Blue Cross Blue Shield of Michigan and Blue Care Network have added a list of vaccines covered under the pharmacy benefit. For a complete listing, see the August 2021 issue of The Record. Virtual Option for BCN plans reduces member cost for telehealth Effective July 1, 2021, large employer groups can choose to purchase a rider for their BCN health plan that lowers out-of-pocket costs when a BCN member accesses care virtually. Members with either a BCN Virtual Option℠ HMO or a BCN Blue Elect Plus Virtual Option℠ POS rider pay less for a virtual visit than an in-person visit. For more information, see Page 1 of the July–August 2021 BCN Provider News. Job aid helps determine if Northwood DME/POS prior authorization is required To help you determine whether a Blue Cross member requires prior authorization for DME/POS through Northwood, a new job aid is available at ereferrals.bcbsm.com that walks you through the steps. For more information, see the August 2021 issue of The Record. Refer members to network DME suppliers only When obtaining durable medical equipment for our members, providers are contractually obligated to obtain equipment from network suppliers; otherwise, members may be responsible for costs. For more information, see the August 2021 issue of The Record. Colorectal cancer screenings coverage update Effective July 1, 2021, Blue Cross and BCN will cover colorectal cancer screenings, beginning at age of 45, for members who are part of National Health Care Reform-compliant groups. For more information, see the August 2021 issue of The Record. Claim editing enhancements coming to MAPPO claims To promote correct coding and assist with payment accuracy, Blue Cross will enhance its claim editing process for Medicare Plus Blue℠ claims with several updates later this year. For more information, see the August 2021 issue of The Record. Claim editing update coming to MAPPO claims with modifier 59 Beginning later in 2021, Medicare Plus Blue℠ will be updating edits applied to claim lines when modifier 59 or related “X” modifiers are appended. These updates will help promote the appropriate use of modifier 59 and improve claim payment accuracy. For more information, see the August 2021 issue of The Record. Reminder: Here’s how to find help You’re trying to get your work done and you run into a Blue Cross Blue Shield of Michigan or Blue Care Network question or problem that you need to solve. Where do you turn? For instructions on getting help online, with Provider Inquiry or your provider consultant, see Page 3 of the January–February 2020 BCN Provider News or the January 2020 issue of The Record. Training updates New eLearning lesson about evaluation and management guidelines is available on provider training website New eLearning training videos to focus on Medicare Star Ratings Lunch and learn webinars for physicians and coders focus on risk adjustment, coding | |
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. |