Download a printable version to read or shareOctober 2019
|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.|
Oncology management program for Medicare Advantage plans begins in January
A new utilization management program for medical oncology for Medicare Plus BlueSM PPO and BCN AdvantageSM members will begin in January 2020. Providers will need to obtain authorizations from AIM Specialty Health® for certain medical oncology and supportive care medications.
How to identify members in the program
To learn more and for the dates of upcoming webinars, see Page 10 of the September –October 2019 BCN Provider News or the October 2019 issue of The Record.
Sign up for additional training webinars
We’re continuing our series of training webinars for health care providers and staff. To find out more and register, see the October 2019 issue of The Record.
Make sure to download and use the most recent forms
To avoid returned forms or delays in processing, use the latest forms found on bcbsm.com or web-DENIS. Download the necessary forms to ensure you’re always completing the most up-to-date versions. We recommend not storing copies of our forms.
We’ve made some changes to increase security on Provider Secured Services
Your online security is important to us, so we’ve made some changes to Provider Secured Services to help make your information and transactions more secure.
The following changes went into effect Sept. 12:
For more details, see Page 1 of the September–October 2019 BCN Provider News or the September 2019 issue of The Record.
HEDIS measure tip sheets and Star measure tips posted on web-DENIS
As part of our ongoing collaborative efforts with our participating physicians to improve health care quality, we’ve updated our HEDIS® measure tip sheets for 2019. The tip sheets highlight specific measures that are included in the Healthcare Effectiveness and Data Information Set, commonly called HEDIS. The tip sheets have been posted on web-DENIS along with our Star measure tips. They cover such topics as:
Click on BCBSM Provider Publications and Resources or BCN Provider Publications and Resources to access them. For example, from BCN Provider Publications and Resources, you would click on Clinical Quality Corner to see both the HEDIS and Star tip sheets. For more information, see the August 2019 issue of The Record and the September 2019 issue of The Record.
Utilization management programs summary document updated
The Summary of utilization management programsfor Michigan providers (PDF) has been updated with the changes listed below and is now available on ereferrals.bcbsm.com. Click BCN or Blue Cross, then the Authorization Requirements & Criteria page (formerly Clinical Review & Criteria Charts):
Medical oncology drugs —
Radiation oncology —
Holiday office closings
Blue Cross and BCN offices will be closed Nov. 28-29 (Thanksgiving).
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.