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March 2013

New report to help primary care physicians achieve new Diagnosis Closure incentive

Obtaining access to Health
e-Blue

If your primary care office does not have access to Health e-Blue, apply today. Go to bcbsm.com/provider, then:

  1. Click on web-DENIS
  2. Click on Provider Secured Services
  3. Under Solutions available through Provider Secured Services, click on Health e-Blue for Blue Care Network patient data and Blue Cross Blue Shield of Michigan Medicare Advantage patient data.

A new Blues Medicare Advantage Diagnosis Closure incentive program for primary care physicians was announced in the January issue of The Record. A new report is expected to be available on Health e-BlueSM by the beginning of March.

The new report will be called Panel -Diagnosis Evaluation and will include Medicare Advantage patients who have historical or suspected conditions but the diagnosis has not been submitted to the Blues yet in the current year. Watch for an update on Health e-Blue with more information.

The report will include:

  • Reported diagnoses in the current year, including all diagnoses reported to the Blues for each patient in the calendar year
  • A list of all historical diagnoses reported in prior years and suspected conditions based on pharmacy claims, medical claims or other supplemental data sources
  • The report allows the physician to submit additional diagnoses, along with the date the patient was seen in the office, or to indicate that the patient does not have a suspected diagnosis
  • A section for the physician’s electronic signature

All diagnoses reported must be:

  • Based on a face-to-face visit with the patient in 2013
  • Addressed with the patient during the face-to-face visit
  • Documented in the patient’s medical record following the Centers for Medicare & Medicaid Services guidelines

This information may be audited by the Blues or by CMS.

Note: The Blues will not provide a paper Diagnosis Evaluation form on web-DENIS as previously communicated. The form will be available solely on Health e-Blue as part of the report described in this article.
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