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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. The latest COVID-19 provider information Changes for the end of the COVID-19 public health emergency Blue Cross Blue Shield of Michigan and Blue Care Network enacted temporary measures to support providers and protect members during the COVID-19 pandemic. Now that the public health emergency is ending, you need to know which temporary measures are continuing and which are ending. Please refer to our Temporary changes due to the COVID-19 pandemic document. Read more:Additional COVID-19 provider communications can be found here:
EDI transitioning to Availity starting in 2023 Blue Cross and BCN will move our electronic data interchange services, known as EDI, to Availity® beginning in August 2023. The EDI transition affects HIPAA* electronic transactions. Read more:*Health Insurance Portability and Accountability Act Learn more about Blue Cross Personalized Medicine℠ BCN’s new precision medicine pharmacogenomics, or PGx, program can help you personalize medications for your patients. Some of your patients may be invited to take a RightMed® PGx test at no cost to them. These patients may want your advice on whether they should take this test. And, once results are available, they’ll want you to determine if their medications should change. Behavioral health telehealth flexibilities for MA members to continue after PHE ends During the COVID-19 public health emergency, the Centers for Medicare & Medicaid Services temporarily waived certain requirements and allowed flexibilities for providing telehealth services for behavioral health care. These flexibilities were extended through Dec. 31, 2024, and some will become permanent. Blue Cross and BCN will follow Medicare telehealth guidelines for our Medicare Plus Blue℠ and BCN Advantage℠ members. Read more: May 2023 issue of The Record 2023 Provider Incentive Program Quality Measure Descriptions document now available The Quality Rewards program is Blue Cross and BCN’s Performance Recognition Program and Physician Group Incentive Program combined. This guide provides reference material to help Blue Cross and BCN providers achieve 2023 Quality Rewards incentives. The booklet can be found on Health e-Blue℠ in the Resources section. Blue Cross expanding covered services for substance use disorders and mental health Effective July 1, 2023, we’ll be paying for the following as standard benefits for all Blue Cross commercial groups:
Prior authorization processes for MESSA members to change June 1 Michigan’s prior authorization law requirements go into effect on June 1, 2023. The Michigan Education Special Services Association manages most prior authorization requests for its members, with exceptions for certain services. A detailed listing of online submission tools for submitting prior authorization requests for MESSA, as well as a new online method for submitting requests to MESSA is available. Read more: May 2023 issue of The Record Don’t miss important Blue Cross and BCN news You’re invited to subscribe to any of our electronic newsletters that help inform health care professionals about Blue Cross and BCN policies and programs. Visit bcbsm.com/providers/newsletters.html to view current issues and sign up to receive emails as new issues are posted. Holiday office closings Blue Cross and BCN offices will be closed May 29 (Memorial Day).
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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. |