|
||
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. Farewell, web-DENIS; hello, Availity Essentials The last day to log in to Provider Secured Services and web-DENIS was Dec. 15. Make sure you’re registered and ready to use Blue Cross and BCN’s new provider portal, Availity® Essentials. Read more: December 2022 issue of The Record Availity is an independent company that contracts with Blue Cross Blue Shield of Michigan and Blue Care Network to offer provider portal services. Prior authorization, billing reminders for SNF interrupted stays for Medicare Advantage members A skilled nursing facility interrupted stay occurs when a patient is discharged from a SNF and is readmitted to the same SNF within three consecutive days. When this occurs the readmission or subsequent stay is considered a continuation of the previous stay and one claim must be submitted for both stays. Read more: How to submit prior authorization requests for inpatient admissions involving elective surgeries When submitting a prior authorization request for a Blue Cross commercial member admitted for an inpatient elective surgical procedure, you should enter only the primary procedure code for the surgery and include the supporting diagnosis code. Read more: December 2022 issue of The Record Holiday office closings Blue Cross and BCN offices will be closed Dec. 23 through Dec. 26 and Dec. 30 through Jan. 2. Reminder: Bill new, corrected original claim when reporting a modifier change on OPC facility claims For Blue Cross Blue Shield of Michigan commercial members, you must bill a new, corrected claim when changing the modifier on an outpatient psychiatric care, or OPC, facility claim. A replacement claim (frequency code 7) can’t be reported in these instances. Read more: December 2022 issue of The Record CareCentrix processes improved for Medicare Plus Blue prior authorization requests As of Nov. 14, 2022, when submitting prior authorization requests for Medicare Plus Blue members who receive home health services in Michigan, a new clinical questionnaire opens in the CareCentrix HomeBridge® portal, which expedites the review process. Read more: December 2022 issue of The Record CareCentrix is an independent company that manages the authorization of home health care services for Blue Cross Blue Shield of Michigan and Blue Care Network members who have Medicare Advantage plans. Intensive services program for children, adults now available for Blue Cross commercial providers A program that’s been successfully developed for Blue Care Network commercial and BCN Advantage℠ members over the past few years is now payable for Blue Cross commercial and Medicare Plus Blue℠ members. Our Adult Intensive Services and Child Intensive Services program provides intensive case management services for members with chronic mental illness. Read more: December 2022 issue of The Record We’re changing our payment policy for lab services billed by independent labs Effective January 2023, Blue Cross is updating our payment policy for laboratory services billed by an independent lab for services provided to members during their inpatient stay at a hospital facility. Read more: December 2022 issue of The Record Ordering transfers from noncontracted ambulance services costs members money Providers must order transfers from contracted (participating) ambulance services when arranging for non-emergency ground transfers. This applies to transfers for Blue Cross commercial, Medicare Plus Blue℠, BCN commercial and BCN Advantage℠ members. Read more: Updated tools available We’ve updated several flyers to assist you with your Blue Cross and BCN patients:
*Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.
| ||
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. |