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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.
Changes effective Jan. 1, 2021 See the December issue of Blues Brief for physician offices for a list of changes in effect Jan. 1. Providers must submit authorization requests to TurningPoint for musculoskeletal procedures As reported in the November 2020 issue of The Record and Page 46 of the November‑December 2020 BCN Provider News, you now need to submit authorization requests for orthopedic, pain management and spinal procedures to TurningPoint Healthcare Solutions, LLC, for most groups and members for dates of service on or after Jan. 1, 2021. For program details, see Musculoskeletal procedure authorizations: Frequently asked questions for providers. For additional information, including important reminders and available training, see Page 36 of the January‑February 2021 BCN Provider News or the January 2021 issue of The Record. Get ready for Availity: How to select an administrator Blue Cross Blue Shield of Michigan and Blue Care Network will move to the Availity® Provider Portal later in 2021. If you’re already an Availity user, you don’t need to do anything to access Blue Cross and BCN information once it’s available. If you’re not currently using Availity, we have some information to help you prepare for the transition. If your organization doesn’t currently participate with Availity, you’ll need to select someone on your team to serve as the Availity primary administrator. Read more about this on Page 1 of the January‑February 2021 BCN Provider News or the January 2021 issue of The Record. After moving to Availity in 2021, many of our current online tools will still be available There will be new things to learn in the move to Availity, but many of the tools that you’re familiar with will remain. The only change will be how to find those tools. Read more in the December 2020 issue of The Record. Health e‑Blue℠ data entry due soon The deadline for entering data in Health e‑Blue for 2020 gaps in care is midnight, Jan. 23, 2021. Data entered after this deadline will not count for 2020 incentives. The deadline for submitting electronic medical record files is Feb. 5, 2021. Holiday office closings Blue Cross and BCN offices will be closed Jan. 18 (Martin Luther King, Jr. Day). Northwood is Blue Cross’ DMEPOS program benefits manager starting Jan. 1 Starting Jan. 1, 2021, Northwood, Inc., will administer and manage all aspects of durable medical equipment, prosthetics, orthotics and medical supply benefits for Blue Cross Blue Shield of Michigan commercial PPO fully‑insured and individual members who reside in the state of Michigan. Only members in groups enrolled in the program are required to participate. For more information, see the January 2021 issue of The Record, as well as the following documents at bcbsm.com/providers: Here are 2021 FEP benefit changes The 2021 Blue Cross and Blue Shield Federal Employee Program® benefit changes will take effect Jan. 1. For an overview of benefit changes, see the January 2021 issue of The Record. Complete information on benefit changes for Standard Option, Basic Option and FEP Blue Focus plans are available at www.fepblue.org/brochure. AIM to handle prior authorization for some high‑tech radiology services for Michigan FEP members Starting Feb. 1, 2021, AIM Specialty Health® will handle select high‑tech radiology services for Michigan Blue Cross and Blue Shield Federal Employee Program members receiving services in Michigan. Providers must request authorization from AIM prior to services being performed. Authorization requests can be submitted on and after Jan. 18, 2021, fully insured for services performed on or after Feb. 1, 2021. For more information, see the January 2021 issue of The Record. We’re expanding access to diabetes monitoring products for commercial members Starting Jan. 1, 2021, diabetes monitoring products, such as glucometers and test strips, lancets, continuous glucose monitors and insulin delivery devices, will be added to the pharmacy benefit for Blue Cross Blue Shield of Michigan commercial and Blue Care Network commercial members. For information on how members will be able to obtain products or supplies through participating pharmacies or DME providers, see the January 2021 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. Our next webinar, Blue Cross 201 ‑ Claims Basics, starts Feb. 3. Our Autism Overview webinar starts Feb. 4. To see all available dates or register, see Page 8 of the January‑February 2021 BCN Provider News or the January 2021 issue of The Record. Help patients get annual health screenings As the new year approaches, BCN is preparing for annual HEDIS® medical record reviews. BCN team members will be contacting provider offices from January to May to request medical records. As always, we appreciate your cooperation and partnership in making HEDIS 2021 a success. Read more on Page 17 of the January‑February 2021 BCN Provider News. | |
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. |