The Record

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April 2018
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Inside this issue for you

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

Professional

PGIP allocation amount to increase for most codes
Blue Cross changing practitioner fees July 1
New opportunities for CQI value-based reimbursement: Find out how to become eligible
Value-based reimbursement and PCMH designation effective dates are changing
Updates to Medicare Plus Blue^SM PPO outpatient claim editing process coming in May
New programs and preauthorization changes to PPO radiology management program take effect July 1, 2018
Ciox Health now retrieving our medical records for Medicare Advantage risk adjustment services
Blue Cross and BCN’s newborn coverage policy changes
Provider forums starting in May
Reminder: Update your Provider Authorization form when changes occur
What you need to know about Blue Cross
Select insulins with comparable alternatives won’t be covered, effective June 1, 2018
We’ll cover Shingrix^® shingles vaccine, beginning April 1, 2018
Certain topical lidocaine products won’t be covered, effective May 1, 2018
Blue Cross to begin contracting with out-of-state home infusion therapy providers
Use flight information form for non-emergency air ambulance authorization requests
Medicare Advantage Diagnosis Closure Incentive program continues in 2018
Reminder: Medicare patients at risk for Type 2 diabetes eligible for new diabetes prevention program starting April 1
Details available on 2018 FEP skilled nursing facility benefit
Medical residents: Here’s how you can join our network
We’re changing the payment policy when evaluation and management services are billed with surgery

All Providers

Reminder: Respond to our provider manuals survey and you could win a prize
Use PARS or web-DENIS for eligibility and benefit information
Battling the opioid epidemic
Billing chart: Blues highlight medical, benefit policy changes

Pharmacy

Select insulins with comparable alternatives won’t be covered, effective June 1, 2018
We’ll cover Shingrix^® shingles vaccine, beginning April 1, 2018
Certain topical lidocaine products won’t be covered, effective May 1, 2018

Facility

Updates to Medicare Plus Blue^SM PPO outpatient claim editing process coming in May
New programs and preauthorization changes to PPO radiology management program take effect July 1, 2018
Blue Cross and BCN’s newborn coverage policy changes
Reminder: Update your Provider Authorization form when changes occur
UAW Retiree Medical Benefit Trust (URMBT) clinic outpatient facility fees will no longer be reimbursed

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