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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. Transfer Medicare Advantage members to post-acute care facilities immediately after appeals are approved You should transfer patients as soon as you receive notification that an appeal has been approved. Don’t wait to receive an authorization number, which will be provided later. Read more: March 2023 issue The Record Voluntary prior authorization ends May 1 Effective May 1, 2023, Blue Cross Blue Shield of Michigan will no longer accept voluntary prior authorization requests. Due to new Michigan prior authorization legislation requirements, Blue Cross will devote its resources to evaluating only those prior authorizations that are required by the patient’s benefit plan. Read more: February 2023 issue of The Record Nonclinical, transitional care program available to members discharged to additional postacute care facilities On Jan. 1, 2023, the program to reduce avoidable inpatient readmissions through a nonclinical, transitional care program expanded to include members who are discharged to additional post-acute care facilities. Read more: Holiday office closings Blue Cross and BCN offices will be closed April 7 (Good Friday) and May 29 (Memorial Day). Behavioral health providers: Use G2212 in place of *99354 and *99355 In January 2023, we posted a provider alert in which we asked behavioral health providers to hold claims for dates of service on or after Jan. 1, 2023, that contain procedure codes *99354 and *99355. These codes are for non-medical behavioral health prolonged services. Here’s what to do: Use HCPCS code G2212 in place of procedure codes *99354 and *99355 for dates of service on or after Jan 1, 2023. Read more: March 3, 2023 provider alert *CPT codes, descriptions and two-digit numeric modifiers only are copyright 2022 American Medical Association. Blue Cross commercial subscriber IDs that started with 99 have changed Some Blue Cross Blue Shield of Michigan commercial group members had subscriber or enrollee IDs that began with 99. In January 2023, the subscriber/ enrollee ID numbers for these members changed. Read more: March 2023 issue of The Record Provider Resources site adds search tool Since launching Blue Cross Blue Shield of Michigan and Blue Care Network’s Provider Resources site, we have continued to expand and improve it. We now have a search tool available to assist you in finding the information you need. Read more: March 2023 issue of The Record New Directions is now Lucet On Jan. 18, 2023, New Directions Behavioral Health changed its name to Lucet, and the company continues to provide the same behavioral health utilization management and case management services to Blue Cross commercial members. Read more: March 2023 issue of The Record Lucet is an independent company that manages authorizations for behavioral health and autism services for Blue Cross Blue Shield of Michigan members who have commercial plans. Here’s what you need to know about SecureCare In July 2022, Blue Cross began working with SecureCare®, an independent network performance management company, to manage the provider utilization process for independent physical therapists, outpatient physical therapy facilities, occupational therapists, speech-language therapists, athletic trainers, and chiropractors. Read more: March 2023 issue of The Record Health care providers in Blueprint for Affordability shared-risk program improve performance Nearly three years after the launch of the Blueprint for Affordability shared-risk payment model, we’re seeing some impressive results. Physicians in Blueprint arrangements improved affordability by more than $70 million, increased overall health care quality and improved patient outcomes. Read more: February 2023 issue of The Record Legislation removes barriers to using buprenorphine to treat people with opioid use disorder The Omnibus Spending Bill, which passed in December, included the Mainstreaming Addiction Treatment Act, which removes many barriers in the prescription of medications for medication-assisted treatment for opioid use disorder, specifically buprenorphine, the most commonly prescribed of the MAT medications. Read more: We’ve made changes to reimbursement policy for psychiatric residential treatment facilities Blue Cross has developed a new reimbursement policy for psychiatric residential treatment facilities, or PRTFs, effective Dec. 1, 2022. With this policy, Blue Cross recognizes diagnosis-specific pricing related to feeding disorders. Read more: February 2023 issue of The Record
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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. |