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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.
TurningPoint musculoskeletal surgical quality and safety management program resources Many useful resources are available to help you navigate the TurningPoint musculoskeletal surgical quality and safety management program. For a complete listing, see the June 2021 issue of The Record. CareCentrix to manage authorizations for home health care for Medicare Advantage members Blue Cross Blue Shield of Michigan and Blue Care Network have contracted with CareCentrix® to manage the authorization of home health care for Medicare Advantage members. For episodes of care starting on or after June 1, 2021, providers will need to request prior authorization from CareCentrix for Medicare Plus Blue℠ and BCN Advantage℠ members. For more information, see Page 17 of the May–June 2021 BCN Provider News or the May 2021 issue of The Record. 2021 Quality Measure Descriptions document available This guide provides reference material to help Blue Cross and BCN providers achieve 2021 Quality Rewards incentives. The 2021 guide also includes a copy of the Telehealth Summary – 2021 HEDIS Measures document. This can be found on BCN Health e-Blue℠, BCBSM Health e-Blue or BCBSM Medicare Advantage Health e-Blue under the Resources section. Concierge practices must comply with Blue Cross affiliation agreements As a reminder, health care providers must comply with their affiliation agreements, as well as ensure that the requirements of the concierge model are permitted by their affiliation agreements with Blue Cross. For more information, see Page 4 of the May–June 2021 BCN Provider News or the June 2021 issue of The Record. We’re using updated utilization management criteria for non-behavioral health and behavioral health services starting Aug. 2, 2021 On Aug. 2, 2021, we’ll begin using the 2021 InterQual® criteria to make utilization management determinations for non-behavioral health services. Read more in the May 2021 ereferrals.bcbsm.com news item. For behavioral health services, read more in the May 2021 ereferrals.bcbsm.com news item. Virtual provider symposiums to focus on patient experience, HEDIS®, documentation and coding Physicians, physician assistants, nurse practitioners, nurses and coders can receive continuing education credits for attending the sessions. For more information, including topics, dates and registration links, see Page 8 of the May–June 2021 BCN Provider News or the June 2021 issue of The Record. HEDIS is a registered trademark of the National Committee for Quality Assurance. Lunch and learn webinars for physicians and coders focus on risk adjustment, coding Sign up now for live, monthly, lunchtime webinars focusing on risk adjustment and coding. These educational sessions will update you on documentation and coding of common challenging diagnoses. To review session topics or register, see Page 35 of the May–June 2021 BCN Provider News or the June 2021 issue of The Record.
New provider training site Beginning June 1, users will be able access recorded webinars, videos, e-Learning modules and other training resources through our new provider training website. To learn more about the site as well as request access, see the June 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. | ||
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. |