Provider News Archives

July 2015

7/2/2015 Blue Medicare Providers: Reminder to Include All Required Information on Claims

7/2/2015 BRCA Test Request Type Added to Blue e Authorization Requests

7/2/2015 Corrected Claims Must Contain Submission Type Codes Effective July 6

7/2/2015 State Health Plan: ValueOptions Is Now Beacon Health Options

June 2015

6/17/2015 BCBSNC Shifts BRCA Testing From Post-Service to Pre-Service Review

6/17/2015 Claims Inventory Update for June 2015

6/17/2015 Reminder: New Provider Quality Report Coming in July

6/11/2015 Customer Service Hours for Providers Will Change in Early July

6/11/2015 Sign Up Today for the Convenience of Electronic Funds Transfer

6/5/2015 Help Your Patients Save Money by Using In-Network Labs

6/3/2015 Register Now for Multi-Payer Expo In Hickory on June 25

6/3/2015 Risk Adjustment Provider Education Webinar in June

6/1/2015 BCBSNC Continues Transition to New Technology Platform

6/1/2015 Notice of Blue Book Addendum and New Reimbursement Policies for Blue Medicare

May 2015

5/27/2015 New Provider Quality Report Coming in July

5/14/2015 Claims Inventory Update for May 2015

5/13/2015 Tobacco Cessation Help Available for Members With ACA-Mandated Preventive Benefits

5/6/2015 2015 Blue Medicare Prospective Risk Adjustment Underway

5/6/2015 Is Tele-Health Right for Your Practice? Find Out More May 13

5/6/2015 Risk Adjustment Provider Webinars in May

April 2015

4/30/2015 Rx Utilization Management Changes Effective July 1, 2015

4/22/2015 2015 Medicare Advantage Risk Adjustment: Medical Records Request Process

4/22/2015 Blue Medicare Insulin Adminstration Benefits

4/22/2015 Pulse8 to Send Care Gap Alerts for Commercial ACA Members

4/16/2015 Claims Inventory Update for April 2015

4/14/2015 Pediatric Preventive Benefits Now Includes Fluoride Varnish for Most Members Under Age 5

4/8/2015 Corrected CMS-1500 Claim Submissions

4/8/2015 Important Clarifications About CPT and HCPCS Code Changes for 2015

4/8/2015 State Health Plan: Nexium 24-Hr OTC Proton-Pump Inhibitor Coverage

4/7/2015 Risk Adjustment Provider Education Webinars for April

March 2015

3/31/2015 Additional CPT and HCPCS Revenue Codes for UB-04 or 837-Institutional Claim Submissions

3/26/2015 Updates to Sleep Apnea Corporate Medical Policy

3/23/2015 Register Now for Multi-Payer Expo in Wilmington

3/19/2015 An Important Clarification About Blue Medicare Essential, A Blue Medicare HMO Product

3/19/2015 Claims Inventory Update for March 2015

3/17/2015 Streamlining the Credentialing and Enrollment Process

3/5/2015 BCBSNC Selects Harvoni as Preferred Hepatitis C Medication

3/2/2015 Risk Adjustment Provider Education Webinars in March

February 2015

2/24/2015 February 2015 Rx Updates

2/23/2015 New Chronic Kidney and End-Stage Renal Disease Management Programs

2/19/2015 FACETS Claims Status Now Available on Blue e

2/18/2015 Claims Inventory Update for February 2015

2/17/2015 Reminder Regarding Behavioral Health Service Codes

2/15/2015 Register Now for Multi-Payer Provider Expo in Greenville

2/11/2015 Advance Beneficiary Notices Disallowed in Billing Noncovered Services for Blue Medicare

2/9/2015 Medication Safety for Blue Medicare Members

2/2/2015 Evidence Required for Mental Health Follow-Up Services After Hospitalization

January 2015

1/23/2015 Risk Adjustment Webinars for Providers in February

1/22/2015 Claim Submission for Mental Health Follow-Up Quality Scoring

1/20/2015 Rx Utilization Management Changes Effective April 1, 2015

1/13/2015 Claims Inventory Update for January 2015

1/13/2015 CPT and HCPCS Code Changes for 2015

1/12/2015 A New Year Means New ID Cards for Some, But Not for All

1/9/2015 Are You Ready for That First-of-the-Year Increase in Rx Prior Authorizations?

1/9/2015 Reminder: BCBSNC Upfront Member Collection Policy

1/5/2015 UPDATED: BCBSNC Claim Filing Guidelines for New CMS X Modifiers

December 2014

12/17/2014 2015 ID Cards for Renewing Health Insurance Marketplace Members

12/17/2014 2015 Member ID Cards Will Include Type of Formulary Information

12/17/2014 Claims Inventory Update for December 2014

12/17/2014 Correction to Benefit Application for the Management of Keratoconus

12/17/2014 Final Reminder to Complete 2014 SOAP Notes for Medicare Advantage Risk Adjustments

12/17/2014 New Exclusive Specialty Pharmacy Provider for ASO Members

November 2014

11/24/2014 A New Way of Managing Skilled Nursing Facility Care for BCBSNC's Blue Medicare Members

11/15/2014 How to Avoid Blue Medicare Claim Mailbacks

11/15/2014 Use ePass to Complete SOAP Notes for Medicare Advantage Risk Adjustments

11/12/2014 Identifying Risk Adjustable Conditions in ACA Commercial Population by Year End

11/7/2014 Claims Inventory Update as of November 7, 2014

October 2014

10/31/2014 New Pediatric Vision Hardware Benefits for 2015

10/31/2014 State Health Plan to Cover Applied Behavioral Analysis for Autism in 2015

10/31/2014 Updates to Vision Care Provider Contracts

10/30/2014 Provider Service Hours Extended During Open Enrollment

10/30/2014 Rx Utilization Management Changes Effective January 1, 2015

10/30/2014 Tell Us About Your Experiences With BCBSNC's Utilization Management and Case Management Processes

10/30/2014 The Affordable Care Act and Medical Records

10/29/2014 Blue Local with Carolinas HealthCare System: A New BCBSNC Product for Charlotte and Gaston Regions

10/17/2014 Ebola Virus Update: From the Office of BCBSNC's Chief Medical Officer, Susan Weaver M.D.

10/15/2014 Behavioral Health Access to Care Survey for Services Provided in 2014

10/15/2014 Reminder for Providers Performing Preventive Screening Colonoscopies

10/3/2014 Revised Hearing Aid Pricing

10/3/2014 Tips for Completing SOAP Notes for Medicare Advantage Risk Adjustment

10/2/2014 2014 and 2015 Seasonal Flu Vaccine Information

10/2/2014 DEA Issues Final Rule Regarding Hydrocodone Combination Products

10/2/2014 Temporary Changes to Provider Location Display in the BCBSNC Provider Directory

September 2014

9/25/2014 Reminder about Venipuncture, Handling and Collection Services

9/23/2014 BCBSNC's Medicare Advantage HMO Products changing in 2015 for 11 North Carolina Counties

9/12/2014 Claims Inventory Update as of September 12, 2014

9/10/2014 Blue e Health Eligiblity Grace Period Display

9/10/2014 Help Secure Your HEDIS Credit by Responding to BCBSNC's Medical Records Request

August 2014

8/28/2014 Notice of Upcoming Medical Code Changes Effective Fall 2014

8/28/2014 The Alliance for a Healthier Generation Survey re Pediatric Obesity

8/21/2014 Tips to Help You Successfully Submit Rx Prior Review Requests via CoverMyMeds

8/13/2014 Change From MAC A to MAC B Prescription Drug Pricing

8/13/2014 Claims Inventory Update as of August 13, 2014

8/13/2014 Controlling High Blood Pressure in Blue Medicare Patients With Diabetes

8/8/2014 Rx Utilization Management Changes Effective October 1, 2014

July 2014

7/23/2014 Follow-Up Visit Within Seven Days Following Inpatient Mental Health Stays

7/23/2014 National Adult Clinical Guidelines for the State Health Plan

7/23/2014 New Member Prefixes and Checks With a New Look

7/17/2014 New HEDIS Tools Available to Help With Quality Measures

7/17/2014 Register Now for Multi Payer Provider Expo in Charlotte

7/16/2014 Claims Inventory Update as of July 15, 2014

June 2014

6/26/2014 Level 1 Provider Appeal Form Required as of September 1, 2014

6/26/2014 Reminder: Skilled Nursing Facility Benefits Only Available for Inpatient Care

6/19/2014 Sign Up for the Convenience of Electronic Funds Transfers

6/13/2014 Behavioral Health Access to Care Survey for Services Provided in 2013

6/12/2014 CoverMyMeds Streamlines Electronic Rx Prior Review Requests

6/2/2014 Medical Policy Changes for Allergy Immunotherapy

May 2014

5/28/2014 BCBSNC Transitioning to New Technology Platform

5/27/2014 Claim Status Messages on Blue e

5/27/2014 Reminder Regarding Behavioral Health Service Codes

5/20/2014 Protecting the Privacy of Our Members

5/20/2014 State Health Plan: Nexium 24HR Added to Over-the-Counter PPIs

5/20/2014 State of Disaster Declared for Many Eastern NC Counties

5/16/2014 Claims Escalation Process for Aged Claims 60 Days or Older

5/13/2014 Why and When Claim Delay Letters Are Sent

5/12/2014 State Health Plan Preferred Insulin Brand Program

5/9/2014 New EOBs for Medicare Advantage Members

5/8/2014 Affordable Care Act: Pediatric and Young Adult Hearing Services

5/5/2014 Claims Inventory Update as of May 5, 2014

5/5/2014 CoverMyMeds Will Provide an Electronic Solution for Rx Prior Review Requests

5/1/2014 Medical Record Requests for BCBSNC Medicare Plans

5/1/2014 Provider Responsibility for Inpatient Precertification Now Includes BlueCard Members

April 2014

4/28/2014 AIM Makes Enhancements to Its Clinical Appropriateness Guidelines for Radiology and Cardiology

4/17/2014 Rx Utilization Management Changes for Spring 2014

4/11/2014 Claims Inventory Update: What BCBSNC Is Doing to Address Your Feedback

4/8/2014 Charlotte Polypharmacy Workshop To Be Held in Late April

4/2/2014 Teaming With Hospitals for Quality Care

March 2014

3/27/2014 Affordable Care Act: Pediatric Vision Services

3/27/2014 Register Now for Upcoming 2014 Multi Payer Expo in April

3/26/2014 Changes to Blue e CMS1500 Claims Transaction This Weekend

3/25/2014 EPA PreService Review for BlueCard Members

3/17/2014 InterPlan Program Host Claims Voucher Deducted in Error

3/17/2014 Save Time and Avoid Frustration by Using Blue e

3/13/2014 BCBSNC Will Only Accept New CMS-1500 Paper Form as of June 1

3/5/2014 BCBSNC to Introduce New Authorization Portal for Providers

3/4/2014 New CMS Guidelines Regarding Prescription Drugs for Hospice Patients

February 2014

2/28/2014 MS DRG Reimbursement Conversion for Hospitals in 2014

2/27/2014 A Reminder About Our Blue Value Network

2/26/2014 Register Now for 2014 BCBSNC Regional Provider Conferences

2/14/2014 A Reminder about Modifiers

2/6/2014 CMS Reminder Regarding Hospice and ESRD Drugs

2/6/2014 Rx Utilization Management Changes Effective April 1, 2014

January 2014

1/31/2014 Call Center Hours for Providers Back to Normal as of February 3

1/31/2014 How to View Other Blue Plans' Medical Policies and Precertification Requirements

1/23/2014 Submitting a Request to AIM for CT Abdomen and Pelvis Combination

1/22/2014 Update: High Risk Medications for Seniors

1/21/2014 BCBSNC Experiencing Claim Processing Delays and Reduced Call Center Hours for Providers

1/17/2014 Reminder: BCBSNC upfront member collection policy

1/15/2014 BCBSNC Experiences Delay in Processing of Member Applications and Issuing New ID Cards

1/14/2014 Online and Print Resources Available to Help You Improve HEDIS Quality Measures

1/9/2014 Customer Service Hours for Providers Temporarily Impacted by High Volume of Member Calls

1/9/2014 Reminder Regarding Reimbursement for Durable Medical Equipment

1/8/2014 2013-2014 Seasonal Flu Vaccine Information

1/8/2014 BCBSNC Launches New Website for Military Members and Their Providers

1/8/2014 Delay in Processing of Corrected Claims Continues

December 2013

12/19/2013 Correct Reporting of HCPCS Code Q0091 for Pap Smear Collection

12/19/2013 Privacy Regarding Member Self-Paid Services or Items

12/16/2013 Important Information Regarding Drug Utilization Management Effective January 1, 2014

12/12/2013 Changes to the Blue Medicare Rx Standard Plan Formulary for 2014

12/12/2013 Determining Cost & Quality Designations

12/11/2013 2014 State Health Plan Pharmacy Benefit Changes

12/11/2013 High-Risk Medications for Seniors

12/10/2013 Help Close Cholesterol and Diabetes Care Gaps for Medicare Advantage Members

12/10/2013 Respond to Medical Records Request From Verisk Health to Help Secure HEDIS Credit

12/4/2013 Access to Care Standards: Focusing on the Medicare Advantage Patient

12/4/2013 Delay in Processing of Corrected Claims

12/4/2013 Rx Basic Closed Formulary Changes Effective January 1, 2014

12/3/2013 Reminder About Level I Provider Appeals

12/3/2013 What You Need to Know About Health Exchanges and Individual Grace Periods

November 2013

11/19/2013 COB Smart to Improve Accuracy of COB in the Health Care Industry

11/18/2013 Prior Approval No Longer Required for UVB Light Therapy--Including Home NB-UVB Units

11/12/2013 Controlling High Blood Pressure in Patients With Diabetes

October 2013

10/30/2013 State Health Plan Changes for 2014

10/18/2013 Behavioral Health Providers: Please Complete Our Access-to-Care Questionnaire

10/18/2013 Rx Utilization Management Changes Effective January 1, 2014

10/10/2013 Revisions to HCR Preventive Services Coding Guide

10/10/2013 State Health Plan Will Have Split Certificates in 2014

10/4/2013 Allowed Documentation for HEDIS Follow Up After Hospitalization Measure

10/4/2013 BlueCard Claim Enhancements for Medicare Statutorily Excluded Services

10/4/2013 Follow-Up Visit to Be Scheduled Within 7 Days After Inpatient Mental Health or Substance Abuse Stays

10/3/2013 Prior Authorization Requirements May Differ for Blue Medicare HMO and PPO Members

September 2013

9/26/2013 Electronic Funds Transfer Available for FEP Business in Early October

9/25/2013 Echocardiography to Be Added to Blue Medicare Diagnostic Imaging Program January 1, 2014

9/24/2013 2013 BCBSNC Provider Satisfaction Survey: Let Us Hear From You

9/24/2013 Providers Play Important Role in Ensuring BCBSNC's Commitment to CMS Compliance

9/24/2013 Resources and Tools to Help Prepare for ICD-10

9/20/2013 Wayne Memorial Hospital Situation

9/17/2013 Global Maternity and Multiple Births Billing Guidelines

9/17/2013 Update Regarding Claims Issue With Lab, Vaccine, and Preventive E&M Codes

9/11/2013 NC's First Accountable Care Alliance Launched

9/4/2013 Disregard Duplicate EFT Payment Notice for Late August

9/3/2013 Annual Chart Data Collection for Medicare Advantage Patients

August 2013

8/28/2013 Rx Utilization Management Change for Stelara Effective November 1, 2013

8/27/2013 BCBSNC Addressing Virtual Hold Features to Better Meet Your Needs

8/23/2013 No Disruption for New Patient Insulin Pump or CGM Device Training

8/14/2013 Incorrect Denials for CPT Codes 99000 and 99051

8/9/2013 Privacy Regarding Member Self-Paid Services or Items

8/9/2013 State of Disaster Declared for NC Western Counties

8/7/2013 Revised: BCBSNC Requirements for Filing Ancillary Claims

8/7/2013 Revised: Billing for Preoperative and Preadmission Services

8/2/2013 New ICD10 Codes Specified in Medical Policies

8/1/2013 Rx Utilization Management Changes Effective October 1, 2013

July 2013

7/19/2013 BCBSA Announces Blue Distinction Centers for Cardiac Care

7/17/2013 State of Disaster Declared for Some North Carolina Counties

7/3/2013 Glucose Strips Unit Increase

7/3/2013 State Health Plan Checks to Be Reissued

June 2013

6/27/2013 Edgepark to Be Sole Distributor of Insulin Pumps and CGMs

6/27/2013 New ADHD Drug and Reminder About July 1 Rx UM Changes

6/27/2013 Updates Regarding the FEP Migration to the Power MHS System

6/19/2013 Preventive Services Coding Under Health Care Reform

6/17/2013 ICD10 Codes Required for Dates of Service Beginning October 1, 2014

6/11/2013 State Health Plan Will No Longer Cover Prescription Medical Foods

May 2013

5/30/2013 Rx Utilization Management Changes Effective August 1, 2013

5/17/2013 Update: FEP Claims Processing Migration Complete

5/15/2013 Adjustments Will Be Applied to Overpaid Medicare Supplement Claims

April 2013

4/25/2013 Referrals to Out of Network Labs Can Increase Expenses for Patients

4/23/2013 Update: Implementation Date for FEP Claims Processing Enhancements Postponed

4/11/2013 Update: New Implementation Date for FEP Claims Processing Enhancements

4/10/2013 April Listening Sessions to Gather Insights About ICD-10 End-to-End Testing

4/3/2013 Register for April National Provider Call About ICD-10 Transition

4/1/2013 Rx Utilization Management Changes Effective July 1

February 2013

2/22/2013 Pomalyst Approved for Treatment of Advanced Multiple Myeloma

2/22/2013 Quicker Access to Online Pharmacy UM Programs

2/21/2013 Behavioral Health Access-to-Care Survey for Services Provided in 2012

2/21/2013 Recent System Upgrade Is Complete

2/14/2013 Reminder: System Upgrade Will Affect Business Operations

2/12/2013 Breast Pump Coding Under Health Care Reform

2/4/2013 System Upgrade Will Affect Business Operations in Mid-February

January 2013

1/29/2013 Changes to Wellmark Pre-Service Review Program

1/29/2013 Include All Original Correct Charges When Filing Corrected Claims

1/14/2013 Rx Utilization Management Changes Effective April 1

1/11/2013 Revised: New Products for 2013: Blue Select and Blue Value

1/10/2013 Patient Relationship Codes Required On Claim Form

1/3/2013 New Drug Onmel Will Require Prior Review

December 2012

12/21/2012 Enforcement of Lithotripsy Billing and Claims Submission Guidelines

12/20/2012 2013 Total Access Provider Training

12/20/2012 Delay in Claim Payments Possible During the Holidays

12/13/2012 BCBSNC Utilization and Case Management Services Survey

12/13/2012 Reminder of Correct Coding Guidelines

12/13/2012 State Health Plan Pharmacy Benefit Changes Effective 1/1/2013

12/12/2012 New Products for 2013: Blue Select and Blue Value

12/12/2012 Update to Orencia, Rituxan and Actemra Prior Review Programs

12/7/2012 AIM Diagnostic Imaging Management Services

12/7/2012 Reminder Regarding Observation Room Services

12/7/2012 Singulair No Longer Requires Prior Review

November 2012

11/29/2012 BCBSNC expands Prime Therapeutics' pharmacy benefit services

11/21/2012 Reissued Multiple Radiology Reimbursement Policy

11/20/2012 Revision: Billing for Preoperative/Preadmission Services

11/20/2012 Revision/Reminder: BCBSNC prior review and certification requirements

11/16/2012 Revision: Prior Review of Certain Services Is Required for Hospital Observation Setting

11/15/2012 Xeljanz Approved for Treatment of Rheumatoid Arthritis

11/13/2012 Healthy Outcomes: New, Integrated Health Management Solution

11/12/2012 BlueWorldWide Expat Product Replaced by GeoBlue

11/12/2012 Childhood Obesity Webinar Open to All Providers

11/12/2012 State of Disaster Declared for Currituck, Dare, Hyde and Tyrrell Counties

11/5/2012 Identifying BCBSNC Members and Identification Cards

11/5/2012 January 2013 Medical Policy Changes: Investigational Procedures

11/2/2012 Blue Medicare HMO and Blue Medicare PPO 2013 Benefit Changes

11/2/2012 Reminder: BCBSNC prior review and certification requirements

11/1/2012 Two-year filing limit for corrected claims

October 2012

10/24/2012 Provider HEDIS Measures

10/22/2012 Revised: Ancillary Claims Filing - BCBSNC Requirements

10/18/2012 Reminder: Real-time Claim Status Available in November

10/15/2012 2012 Annual Health Insurance Institute (HII) Conference

10/15/2012 BCBSNC Monitors Meningitis Outbreak

10/12/2012 Behavioral Health Access to Care Survey

10/12/2012 Use BCBSNC-Provided Fax Forms for Rx Review to Avoid Delays

10/10/2012 UPDATE: Blue Coverage for Regence HealthWise Members Will NOT Terminate

10/1/2012 Blue Coverage for Regence HealthWise Members Terminated

September 2012

9/24/2012 2012 Stick It to the Flu - Seasonal Flu Program

9/24/2012 Blue365: Local and National Discounts for Members

9/24/2012 Rx Prior Review and Quantity Limit Changes - Effective 1/1/2013

9/19/2012 Duplicate Claims Handling for Medicare Crossover

9/11/2012 State of Disaster Declared for Halifax and Northampton Counties

9/10/2012 Notification of Medical Policy Revision: CPT 99420

August 2012

8/31/2012 Medicare Pricing Policy Update

8/31/2012 Update: Ancillary Claims Filing - BCBSNC Requirements

8/31/2012 Update: Drug Wastage Policy effective November 1

8/27/2012 AIM Clinical Guidelines Effective Nov. 1

8/27/2012 BlueCard Claims Incorrectly Filed as Corrected Claims to Be Returned

8/13/2012 Prior Review of Certain Services Is Required for Hospital Observation Setting

8/2/2012 2012 Consumer Transparency Updates

July 2012

7/31/2012 Enforcement of Correct Coding Guidelines

7/27/2012 Prior Review Required for Qsymia

7/27/2012 Real-time Claim Status Coming October 2012

7/27/2012 Reminder About Waivers

7/20/2012 Reminder CAQH and Credentialing/Enrollment with BCBSNC

7/20/2012 Update Imp Date to Change for FEP Claims Processing Enhancements - Making the Move to the Power MHS

7/20/2012 Update and Reminder: Duplex Printing of EOPs for Medicare Advantage and Medicare Supplement

7/5/2012 Self-Administered Drug List Changes effective August 9th

7/5/2012 UPDATE: AIM and Simultaneous Ordering of Multiple Imaging Tests

June 2012

6/29/2012 Rx Prior Review and Quantity Limit Changes Effective 10/1/2012

6/21/2012 Ancillary Claims Filing - BCBSNC Requirements

6/18/2012 AIM and Simultaneous Ordering of Multiple Imaging Tests

6/15/2012 Reminder about Ancillary Service Referrals

6/6/2012 EFT Expansion to Medicare Advantage Lines of Business

6/1/2012 FEP Claims Processing Enhancements

May 2012

5/25/2012 BlueCard and Corrected Claim Submissions

5/22/2012 Update Regarding Proposed Changes to Multiple Radiology Reimbursement Policy

5/9/2012 Changes to Topical Retinoids Age Criteria

5/3/2012 Billing for Preoperative/Preadmission Services - new requirement effective 6/15/2012

April 2012

4/26/2012 Orthotics and prosthetic appliances and appropriate use of RT/LT modifiers

4/26/2012 Reporting physical status modifiers on anesthesia claims

4/20/2012 Participating hospitals and non-billable medical supplies

4/17/2012 State Health Plan Weight Loss Medication Prior Authorization Programs

4/4/2012 State of Disaster Declared for Cherokee County

March 2012

3/29/2012 REMINDER: Prime Therapeutics Is Our New PBM

3/29/2012 Rx Prior Review and Quantity Limit Changes for July 1

3/20/2012 State Health Plan Atypical Antipsychotic Step Therapy Program

3/20/2012 State Health Plan Fertility Medication Pharmacy Changes

3/14/2012 Reminder: BCBSNC system edits apply correct coding guidelines

3/8/2012 Effective April 10, 2012 - CPT and HCPCS Codes to be Included on UB-04 Claim submissions

3/1/2012 HHS Announces Intent to Delay ICD-10 Compliance Date

February 2012

2/29/2012 NOTICE: Delhaize America Member Mailing

2/10/2012 State Health Plan Specialty Medication Quantity Limit Program

2/7/2012 Prior Review Now Required for Ivacaftor (Kalydeco)

2/3/2012 NC Health Choice Processing Transition - Time is Running Out!

2/2/2012 Prime Therapeutics: New PBM as of April 1

2/2/2012 State of Disaster Declared - Burke and Rutherford Counties

January 2012

1/27/2012 2012 ICD-10-CM Training for Provider Office - hosted by NC AHEC

1/12/2012 Facet Joint Denervation Requires Prior Review as of April 1

1/12/2012 Observation Room Services - Reminder

1/12/2012 Reminder about Preventive Screening Colonoscopies

1/5/2012 NC State Health Plan Signs Agreement Giving Access to Carolina Advanced Health

1/4/2012 2012 Total Access Provider Training

1/4/2012 Ambulance Transport Reimbursement Guidelines for Commercial and State PPO Benefit plans

1/3/2012 Redesigned BCBSNC Provider Web Portal

December 2011

12/21/2011 Diagnostic Imaging Reminder for Suppliers of the Technical Component When Providing Services for Medicare Beneficiaries - Beginning January 1, 2012

12/21/2011 SHP Pharmacy Updates - effective 1/3/2012

12/16/2011 Omnitrope is BCBSNCs Growth Hormone Medication of Choice

12/7/2011 BCBSNC and UNC Health Care Open Carolina Advanced Health

12/7/2011 BCBSNC requires all covered entities to be ready for HIPAA 5010 compliance as of January 1, 2012

12/1/2011 Prior Review Updates - effective 3/01/2012

November 2011

11/30/2011 Cialis Approved for Treatment of Benign Prostatic Hyperplasia

11/30/2011 State of Disaster Declared for Randolph and Davidson Counties

11/28/2011 Provider Request and Update: BCBSNC Requires CPT and HCPCS Codes to Be Included On UB-04 Claim Submissions

11/21/2011 CareCentrix "News Flash" Intended for BCBSFL Providers Only

11/16/2011 Annual Member Mailing Begins This Week

11/16/2011 Changes to Specialty Care Case Management for 2012

11/14/2011 EOB Redesigned to Improve Member Experience

11/9/2011 What providers should know about the SilverSneakers®1 Fitness Program

11/4/2011 A Reminder About Observation Room Services

11/4/2011 Expansion of Diagnostic Imaging Management Program to Echocardiography

11/4/2011 Health Programs Help Members Make Key Lifestyle Changes

October 2011

10/31/2011 New BCBSNC Provider Service Model Effective November 1, 2011

10/21/2011 New Provider Service Model

10/12/2011 Reminder: Prior Approval Requirements for Blue Medicare HMO and Blue Medicare PPO

10/7/2011 SHP Announces New Maternity Incentives Program

10/6/2011 BCBSNC and UNC Health Care Announce New Joint Medical Practice to open in late 2011

September 2011

9/30/2011 Multiple Radiology Procedures

9/29/2011 2011 Stick It to the Flu® - Seasonal Flu Program

9/29/2011 BCBSNC Announces New Initiative to Connect and Support Independent Primary Care Physicians and Free Clinics across North Carolina to Enhance Quality of Care

9/23/2011 Effective October 3, 2011 - SHP Requires Prior Authorization for Topical tretinoin and tazarotene

9/14/2011 NC Health Choice Claims Processing Transition

9/9/2011 Reference Laboratories ONLY - Changes to reimbursement of 99000 and 99001 effective Sept 1, 2011

9/9/2011 Reminder: BCBSNC Requires CPT and HCPCS Codes to Be Included On UB-04 Claim Submissions

August 2011

8/26/2011 BCBSNC Policy on Third Party Ordering of DIM Services

8/26/2011 Effective October 1, 2011, New Prior Review and Quantity Limitations Changes

8/19/2011 Clarification for Billing Pediatric Immunization Administration CPT Codes 90460 and 90461

8/19/2011 HIPAA 5010 Transaction & Code Sets

8/12/2011 2011 Annual Provider Conferences

8/5/2011 Reporting Units of Service in Claim Field 24G

July 2011

7/29/2011 BCBSNC eliminates manual refund requests to providers

7/22/2011 Making Cost and Quality Information Available to BCBSNC Customers

7/15/2011 Multiple Radiology Procedure Payment Reduction

7/8/2011 Clear Claim Connection and Correct Coding Initiative Edits

7/8/2011 Diagnostic Imaging Management (DIM) Provider Update - June 2011

7/8/2011 Message for Providers Performing Preventive Screening Colonoscopies

7/8/2011 Specialty Pharmacy Program Changes - effective 7/1/2011

June 2011

6/30/2011 Effective July 1, 2011, prior review for analgesics

6/30/2011 Effective July 1, 2011, prior review for misc rx

6/30/2011 Effective July 1, 2011, Prior review updates for acne rx

6/30/2011 Non-Emergency Ambulance Transport Reimbursement Guidelines

6/24/2011 2011 BCBSNC Provider Conferences - Register Today!

6/8/2011 Drug Wastage Policy effective September 1, 2011

6/3/2011 HIPAA 5010 Transaction and Code Sets Update

May 2011

5/17/2011 Drug Wastage Policy Update

April 2011

4/29/2011 Mailing address change for Blue Medicare HMO and Blue Medicare PPO overpayments


4/15/2011 Changes to existing medical policies taking effect June 2011

4/15/2011 Updates to provider claims refund request form

4/15/2011 Whats New: Medicaid Eligibility Retiring on Blue e -7/1/11

4/6/2011 Imaging Management Program for Boeing Employees

4/1/2011 Blue Cross and Blue Shield of North Carolina (BCBSNC) is conducting a short survey with our provider community

4/1/2011 Notification Concerning Upcoming Reprocessing of CMS Claims Affected by the Affordable Care Act and 2010 Medicare Physician Fee Schedule Changes

March 2011

3/25/2011 Notice: Effective April 1, 2011, BCBSNC to require all Skilled Nursing Facilities (SNFs) to include Resource Utilization Groups (RUGs) on all claim forms

3/18/2011 State Health Plan Pharmacy Coverage Changes for April 1, 2011

3/11/2011 Effective April 1 2011, Updates to Prior Review List

3/4/2011 ICD-10 National Provider Teleconferences

February 2011

2/25/2011 Reminder for providers ordering diagnostic imaging services

2/22/2011 CMS to retroactivley reprocess a large volume of Medicare fee-for-service claims

2/4/2011 Never Events and Hospital Acquired Conditions (HACs)

January 2011

1/31/2011 Network Management Phone Number Change

1/28/2011 2011 FEP Coverage Guidelines for Morbid Obesity Surgery

1/28/2011 Notice: Effective April 1, 2011, BCBSNC to require all Skilled Nursing Facilities (SNFs) to include Resource Utilization Groups (RUGs) on all claim forms

1/14/2011 New Pediatric Immunization Administration CPT Codes Starting January 1, 2011

1/7/2011 How Are Medical Necessity Decisions Made?

December 2010

12/30/2010 Announcing Blue Advantage Saver Plans

12/30/2010 Future Development of National Consumer Cost Tool for BCBSNC Members

12/22/2010 Notice: Implementation of ClaimCheck® to our Medicare Advantage Plans effective March 7, 2011

12/17/2010 24-Hour Response Time for Urgent Authorization Requests: Effective January 3, 2011

November 2010

11/19/2010 Reminder: Diagnostic imaging management program expanded to Blue Medicare HMOSM and Blue Medicare PPOSM products

11/12/2010 2010 HII Workshops

11/5/2010 NC Hearing Aid Mandate Effective for January 1, 2011

11/5/2010 New & Improved AIM Provider Portal Home Page

11/1/2010 SHP requires Prior Authroization for Topical Diclofenac Products

11/1/2010 SHP Requires Prior Authorization for Androgen and Anabolic Steroid

11/1/2010 SHP Requires Prior Authorization for CNS Stimulants

11/1/2010 SHP Requires Prior Authroization for Solodyn

October 2010

10/22/2010 Requests for authorization for DIMP services performed after-hours, on weekends, or during holidays for Blue Medicare

10/8/2010 2010/2011 Flu Vaccine Information

10/1/2010 View Out-of-Area Blue Members Medical Policy and Pre-certification Requirements Online

September 2010

9/24/2010 HIPAA 5010 Transaction and Code Sets

August 2010

8/27/2010 BCBSNC to decrease claims payment runs beginning October 15, 2010

8/13/2010 Access to Out-of-Area Blue Members Medical Policy and Pre-certification Requirements Coming Soon!

8/13/2010 Secure Email from BCBSNC

8/12/2010 Modifiers -54, -55 and -56 to be added to BCBSNC Corporate Medical Policy for Modifier Guidelines

8/6/2010 Updated CLIA Certificate Reminder

July 2010

7/30/2010 Multiple Surgery Reduction Changes

7/21/2010 HIPAA 5010 Transaction and Code Sets

7/16/2010 2010 Provider Conferences

7/1/2010 Reminder: Claim filing time limitation

June 2010

6/28/2010 Federal Mental Health Parity

6/18/2010 October 2009 Contract Addendum Update

6/1/2010 Diagnostic Imaging Management Extended to Blue Medicare HMO and Blue Medicare PPO

May 2010

5/7/2010 Blue Medicare HMO and Blue Medicare PPO Plans become BCBSNC

April 2010

4/23/2010 Proper claim filing, modifiers for "Never Events"

4/16/2010 New Pharmacy Step Therapy Program for the State Health Plan for Teachers and State Employees

4/1/2010 Effective 7/01/10 Stelara, Actemra, Synagis and ARBs will require prior review

March 2010

3/12/2010 FEP Denials for EOBs

3/10/2010 NPI Requirement for form locator 32 of the CMS-1500

3/3/2010 HIPAA 5010 Transaction Sets

December 2009

12/17/2009 Change in Coverage for SSRI Antidepressants, Triptans, and Hypnotic Agents

12/15/2009 Prolonged Care Changes for 2010

12/1/2009 Walmart Benefits for 2010

November 2009

11/20/2009 Blue Medicare HMO and Blue Medicare PPO referrals to DMEPOS suppliers

11/1/2009 H1N1 Immunizations

October 2009

10/20/2009 Medicare Supplement EFT to resume

10/19/2009 IDTFs Require Prior Approval

10/1/2009 2009 HII Workshops - See BCBSNCs presentation

10/1/2009 2010 Medicare Formulary Changes

September 2009

9/18/2009 Proton Pump Inhibitors (PPI) Update

9/1/2009 Controlling Costs

9/1/2009 December 1, 2009 - BCBSNC to require Present on Admission indicators

9/1/2009 Effective October 1, 2009, Change in Intranasal Steroids, Oral Bisphosphonates and Proton Pump Inhibitor Coverage

9/1/2009 Effective October 1, 2009, Symponi Will Require Prior Review

August 2009

8/15/2009 Reminder: CPT Codes 95115 and 95117 - One (1) unit only, when billing for one or more injections given on the same day

July 2009

7/30/2009 Medication Dedication

7/15/2009 Important Reminders about Corrected Claims

7/1/2009 2009 Spring Provider Conferences

7/1/2009 CPT and HCPCS Code Requirements for UB-04

June 2009

6/29/2009 New Pre-Existing Condition Medical Information Request Form

6/29/2009 Reminder: Coverage of Investigational and Cosmetic Services

6/5/2009 5010 Communications - Q & A

April 2009

4/24/2009 Three Drugs added to Prior Review list as of July 1

4/20/2009 Information about Your Fee Schedule

4/8/2009 Discontinuation of Paper Remittances (NOPs/EOPs)

November 2008

11/7/2008 Important changes concerning replacement of current ICD-9 diagnosis codes with ICD-10 codes

October 2008

10/13/2008 Provider Level 1 Appeals Timeframe

August 2008

8/1/2008 IPP Moves to the Power MHS Claims System

July 2008

7/1/2008 Change in Proton Pump Inhibitors (PPI) Coverage

7/1/2008 Mental Health Parity

7/1/2008 NC Smart Choice

7/1/2008 New Prior Review Medications

June 2008

6/23/2008 BCBSNC Spring Provider Conferences - 2008

May 2008

5/1/2008 EOP Enhancement

January 2008

1/16/2008 BlueCard Move to Automatic Crossover for All Medicare Claims

1/1/2008 Introducing Blue Medicare HMO and Blue Medicare PPO - Find out what you need to know!

November 2007

11/30/2007 2007 HII Workshops - See BCBSNCs presentation

September 2007

9/24/2007 BCBSNC Summer Provider Conferences – 2007

August 2007

8/20/2007 More Improvements to Our Automated Phone System!

April 2007

4/30/2007 Notice: BCBSNC is Extending the Acceptance Period of the CMS-1500 (12-90) version claim form

4/2/2007 BCBSNC Ends Kidney Disease Program

March 2007

3/12/2007 Attention Rural Health Clinics: Important Notice About Medicare Crossover Claims

January 2007

1/8/2007 Blue Cross and Blue Shield of North Carolina Remains Committed to Excellent Health Care Quality

1/8/2007 Federal Employee Program Adding Magellan Health Services as Vendor

1/8/2007 Updated Federal Employee Program (FEP) Voucher Deduction Process

November 2006

11/20/2006 BCBSNC to Adopt the New UB04 Claim Form

11/20/2006 Diagnostic Imaging Management Program begins in 1st Quarter 2007

11/13/2006 FEP Venipuncture Charges

October 2006

10/2/2006 New Information about State Members Enrolled in Blue Options PPO

September 2006

9/25/2006 BCBSNC to Adopt the New CMS-1500 Claim Form – Version 08/05

9/25/2006 New Form for Provider-Initiated Refunds for Out-of-Area Members

9/25/2006 Provider Resolution Form: New Form – New Address

9/11/2006 BCBSNC to Provide Flu Vaccine

July 2006

7/5/2006 BlueCard Fund Distribution Program Launched in July

7/5/2006 Medicare Claims Adjustments

7/5/2006 Policy Change for CPT Code 99051

7/5/2006 State Health Plan Offers New PPO Products to Employees

June 2006

6/1/2006 Specialty Pharmacy Update

May 2006

5/15/2006 Outpatient UB92 Claims Filing Update

February 2006

2/16/2006 Explanation of Usual, Customary and Reasonable reimbursement methodology

October 2005

10/5/2005 EDI Services Provider Workshops This October!

August 2005

8/24/2005 Inquires and Appeals Updates & Reminders

8/17/2005 Changes to your BCBSNC Explanation of Payment (EOP)

July 2005

7/20/2005 Blue e Medicaid Eligibility Modifications to Change after August 14

7/20/2005 Correct your Professional (837) Claims Electronically

7/20/2005 Use Blue e for Review of Admission/Treatment Notifications

March 2005

3/2/2005 Credentialing for Registered Dieticians

February 2005

2/9/2005 Changes to prior approval and inpatient admission certification requirements

2/9/2005 Claims for anesthesia must be filed with nationally recognized code set

2/9/2005 Coordination of benefits policy for group claims: spouses and dependent children

2/9/2005 Enhancement of claim submission and reimbursement policy disclosure

2/9/2005 Protecting BCBSNC member Social Security numbers

2/9/2005 Revision to multiple surgical procedure guidelines

2/9/2005 Submitting HIPAA Compliant Claims

2/9/2005 Update: Coordination of benefits claims submission and processing requirements

December 2004

12/15/2004 Becoming a Medicaid Provider

October 2004

10/1/2004 BCBSNC and North Carolina General Statute (NCGS) §58-3-227

September 2004

9/1/2004 SSN ID Replacement Project Q&A for Providers

May 2004

5/12/2004 Share your thoughts in provider survey for your chance to win

March 2004

3/13/2004 Changes to your BCBSNC Notification of Payment (NOP) and Explanation of Payment (EOP)

3/3/2004 Drug Prior Approval and Quantity Limitations Now Include PPO and POS

February 2004

2/25/2004 BCBSNC and North Carolina General Statute (NCGS) 58–3–227 (House Bill 1066)