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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.
RC Claim Assist update Starting May 1, 2021, you must go through Provider Secured Services to access RC Claim Assist. For more information, see Page 32 of the May–June 2021 BCN Provider News or the May 2021 issue of The Record. Qualified providers invited to apply for designation in BDC Substance Use Treatment program Qualified facility providers are urged to apply for national designation as a Blue Distinction® Center for Substance Use Treatment and Recovery. This is the newest BDC designation. It recognizes providers that have demonstrated expertise in delivering quality specialty care in this area safely, effectively and cost efficiently. For more information, see Page 1 of the May–June 2021 BCN Provider News or the May 2021 issue of The Record. Clinical info will be used to validate answers in e-referral Beginning June 2021, we’ll pend some authorization requests that would usually be auto-approved based on responses to questionnaires in the e-referral system. We’ll review and verify that the clinical information provided supports your responses to the questionnaire and make a determination on the request. For more information, see Page 36 of the May–June 2021 BCN Provider News or the May 2021 issue of The Record. Patient experience survey We are launching a new Medicare Advantage member survey to assess patient experience. A Centers for Medicare & Medicaid Services-certified vendor will mail the survey beginning in June 2021, with online and phone completion options. For more information, see Page 16 of the May–June 2021 BCN Provider News or the May 2021 issue of The Record. Holiday office closings Blue Cross and BCN offices will be closed May 31 (Memorial Day). Musculoskeletal authorization requests for URMBT non-Medicare members UAW Retiree Medical Benefits Trust non-Medicare members will need prior authorization for certain musculoskeletal procedures scheduled on or after May 31, 2021. Providers can submit prior authorization requests to TurningPoint starting May 3, 2021. For more information, see the May 2021 issue of The Record. PPUR can affect value-based reimbursement Value-based reimbursement is available to practitioners who meet the criteria for quality improvement programs developed as part of Value Partnerships and the Physician Group Incentive Program. Practitioners become ineligible for reimbursement if Blue Cross places them on Prepayment Utilization Review, or PPUR. For more information, see the May 2021 issue of The Record. Training update reminders Lunch and learn webinars for physicians and coders Latest on-demand training available now Upcoming virtual provider symposiums
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Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. |