The Record

The Record - Insurance Card with the BCBSM/BCN Cross and Shield logo that reads, Blue Cross Blue Shield, Blue Care Network of Michigan. Tagline: Confidence comes with every card. Image of Note boards with paper that has the letters RX on it accompanied by a stethoscope

Subscribe | The Record Archive | Contacts | bcbsm.com

December 2017
Picture of physician

The way you look up authorizations is changing
Do you currently use web-DENIS to determine the status of authorization requests? If so, you’ll need to follow a different process going forward. Read more.

Inside this issue for you

See all the articles in this issue, grouped by category, below.

Professional

We have new value-based reimbursement opportunities for specialists participating in CQIs
Medicare Plus Blue^SM PPO updating claim editing processes
Complete your fourth-quarter attestation through CAQH ProView
Report national drug code number on Medicare Advantage PPO drug claims for accurate processing
Online health care services to include behavioral health
Reminder: We need you to update information for practitioners, locations that don’t accept appointments
Certain hospital outpatient infusions no longer covered without additional authorization
Announcing 2018 coverage changes to MPSERS members’ hearing, vision services
Reminder: UAW Retiree Medical Benefits Trust coverage changing for Medicare members in 2018
Avoid use of imaging studies for low back pain in first six weeks unless an exclusion applies
Encourage your patients to be screened for cervical cancer

All Providers

The way you look up authorizations is changing
ClaimsXten™ upgrade brings enhancements to Clear Claim Connection
Reminder: Online training for prior authorization program begins in December
We’re making a change in how some groups handle preauthorizations for proton beam therapy
We’re updating our MA PPO clinical editing appeals process
Battling the opioid epidemic
Make sure prescriptions are signed by a qualified prescriber
Here are some highlights of changes to 2018 products, health care options
We’re offering 28 products for the individual marketplace in 2018
Blue Cross will administer physical therapy benefits for Ford UAW Trust Medicare retirees
Coding corner: Proper coding for major depressive disorder
Billing chart: Blues highlight medical, benefit policy changes

Facility

Medicare Plus Blue^SM PPO updating claim editing processes
Certain hospital outpatient infusions no longer covered without additional authorization
Announcing 2018 coverage changes to MPSERS members’ hearing, vision services
Reminder: Don’t resubmit claims involved in audits
We’ve changed how behavioral health facilities handle certain requests for Medicare Plus Blue^SM members
Reminder: Review, confirm your demographic data

Pharmacy

High-cost insulins with comparable alternatives among Blue Cross and BCN’s Custom Select drug list exclusions

DME

We’re changing the way we process DME HCPCS codes, effective March 1, 2018

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

Blue Cross Blue Shield of Michigan and Blue Care Network of Michigan are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association.

We respect your right to privacy - view our policy.