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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. AIM changed its name to Carelon In March 2023, AIM Specialty Health® changed its name to Carelon Medical Benefits Management. The name change doesn’t affect how the company works with providers. Read more: April 2023 issue of The Record Changes to Carelon’s provider portal for medical oncology program On May 14, 2023, Carelon Medical Benefits Management (formerly AIM Specialty Health®) will release enhancements to the provider portal for the medical oncology program, and the look and functionality of the clinical intake screens will change. Read more: April 2023 issue of The Record How to determine prior authorization requirements for patients with non-Michigan Blue plans Michigan providers can find information about prior authorization requirements for patients with non-Michigan Blue plans as follows:
Read more: April 2023 issue of The Record Prior authorization changes coming in June Michigan’s prior authorization law requirements go into effect on June 1, 2023. These requirements apply to health care insurers and providers in Michigan for members who have commercial coverage. Read more: April 2023 issue of The Record What to do when voluntary prior authorization ends May 1 The February 2023 issue of The Record announced voluntary prior authorization requests ending on May 1. If you have a procedure coming up after May 1 and you’re not sure whether it will be covered or not, there are some steps you should take. Read more: April 2023 issue of The Record Additional precision medicine and pharmacogenomics education opportunities On Jan. 1, 2023, Blue Care Network launched an end-to-end precision medicine pharmacogenomics, or PGx, program called Blue Cross Personalized Medicine℠. You can learn more about pharmacogenomics by attending our free upcoming educational session for oncology providers on Wednesday, April 26, or Wednesday, May 24, for behavioral health providers. Reminder: Providers have a new email box to reach provider consultants Blue Cross and BCN want to make it easier and simpler for you to reach a provider consultant when you need to escalate a provider inquiry. To this end, providers in the East, Mid and Southeast regions now have a new email box to use: petcontactus@bcbsm.com. Read more:Availity® is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal services. Blueprint allocation amount of 1.5% to go into effect July 1, 2023 We’ll be introducing a 1.5% allocation from Blue Cross commercial (PPO) professional fees to fund Blueprint risk arrangements for our Blue Cross commercial providers, starting July 1, 2023. These risk arrangements will be partially offset by our annual professional fee schedule update that will also take place starting July 1. Read more: April 2023 issue of The Record Holiday office closings Blue Cross and BCN offices will be closed April 7 (Good Friday). Reminder: Double-check Blue Cross commercial members’ coverage for COVID-19 vaccines Some Blue Cross commercial members have group plans that are exempt from complying with Affordable Care Act requirements. During the public health emergency, we’ve been covering 100% of the costs for administering COVID-19 vaccines to these members. Effective April 1, 2023, these members will revert to their pre-pandemic vaccine coverage, unless their group requested otherwise. As a result, they may have out-of-pocket costs or may not have vaccine coverage Read more: April 2023 issue of The Record We’re updating COVID-19 provider communications in preparation for end of public health emergency On Jan. 30, 2023, the federal government announced it will end the public health emergency on May 11. Blue Cross and BCN enacted temporary measures to support health care providers and protect members during the COVID-19 pandemic. Read more: April 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. |