Provider News Archives
- June 2013
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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
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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
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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 Promote Exercise With the SilverSneakers Fitness Program
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
- February 2013
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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
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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
1/3/2013 SilverSneakers Fitness Program
- December 2012
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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
- November 2012
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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
- October 2012
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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
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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
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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
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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
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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
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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
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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
- March 2012
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3/29/2012 REMINDER: Prime Therapeutics Is Our New PBM
3/29/2012 Rx Prior Review and Quantity Limit Changes for July 1
3/29/2012 The SilverSneakers Fitness Program
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
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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
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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
- December 2011
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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
- November 2011
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11/30/2011 Cialis Approved for Treatment of Benign Prostatic Hyperplasia
11/30/2011 State of Disaster Declared for Randolph and Davidson Counties
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
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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
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9/30/2011 Multiple Radiology Procedures
9/29/2011 2011 Stick It to the Flu® - Seasonal Flu Program
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
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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
- July 2011
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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
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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!
- May 2011
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5/17/2011 Drug Wastage Policy Update
- April 2011
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4/29/2011 Mailing address change for Blue Medicare HMO and Blue Medicare PPO overpayments
4/21/2011 HOME INFUSION THERAPY QUICK REFERENCE GUIDE
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
- March 2011
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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
- February 2011
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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
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1/31/2011 Network Management Phone Number Change
1/28/2011 2011 FEP Coverage Guidelines for Morbid Obesity Surgery
1/14/2011 New Pediatric Immunization Administration CPT Codes Starting January 1, 2011
- December 2010
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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
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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
- October 2010
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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
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9/24/2010 HIPAA 5010 Transaction and Code Sets
- August 2010
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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
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7/30/2010 Multiple Surgery Reduction Changes
7/21/2010 HIPAA 5010 Transaction and Code Sets
7/16/2010 2010 Provider Conferences
- June 2010
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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
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5/7/2010 Blue Medicare HMO and Blue Medicare PPO Plans become BCBSNC
- April 2010
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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
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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
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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
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11/20/2009 Blue Medicare HMO and Blue Medicare PPO referrals to DMEPOS suppliers
11/1/2009 H1N1 Immunizations
- October 2009
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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
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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, Symponi Will Require Prior Review
- August 2009
- July 2009
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7/30/2009 Medication Dedication
7/15/2009 Important Reminders about Corrected Claims
7/1/2009 2009 Spring Provider Conferences
- June 2009
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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
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4/24/2009 Three Drugs added to Prior Review list as of July 1
4/20/2009 Information about Your Fee Schedule
- November 2008
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11/7/2008 Important changes concerning replacement of current ICD-9 diagnosis codes with ICD-10 codes
- October 2008
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10/13/2008 Provider Level 1 Appeals Timeframe
- August 2008
- July 2008
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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
- May 2008
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5/1/2008 EOP Enhancement
- January 2008
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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
- September 2007
- August 2007
- April 2007
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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
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3/12/2007 Attention Rural Health Clinics: Important Notice About Medicare Crossover Claims
- January 2007
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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
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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
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10/2/2006 New Information about State Members Enrolled in Blue Options PPO
- September 2006
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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
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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
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6/1/2006 Specialty Pharmacy Update
- May 2006
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5/15/2006 Outpatient UB92 Claims Filing Update
- February 2006
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2/16/2006 Explanation of Usual, Customary and Reasonable reimbursement methodology
- October 2005
- August 2005
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8/24/2005 Inquires and Appeals Updates & Reminders
8/17/2005 Changes to your BCBSNC Explanation of Payment (EOP)
- July 2005
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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
- February 2005
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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
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12/15/2004 Becoming a Medicaid Provider
- October 2004
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10/1/2004 BCBSNC and North Carolina General Statute (NCGS) §58-3-227
- September 2004
- May 2004
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5/12/2004 Share your thoughts in provider survey for your chance to win
- March 2004
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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
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2/25/2004 BCBSNC and North Carolina General Statute (NCGS) 58–3–227 (House Bill 1066)