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January 2020
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Blue Cross and 7 health organizations will share financial risk for patient care and health

We’re pleased to announce that Blue Cross Blue Shield of Michigan and seven health organizations have agreed to a next-generation value-based incentive agreement as part of our Blueprint for Affordability. Read more.


Inside this issue for you

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

Professional
Reminder: Attend webinar to learn about medical oncology program for MA members
Sign up for additional training webinars
PPO inpatient admission requests submitted through e-referral could be subject to clinical review
Provider Enrollment may request new signature document for Association audit
Reminder: Direct reimbursement available to clinical nurse specialists, beginning Jan. 1
We’re aligning peer-to-peer review request processes for acute non-behavioral health non-elective inpatient admissions
TurningPoint to handle authorization requests for musculoskeletal procedures with dates of service on or after June 1 for Medicare Advantage, BCN members
Free waiver training opportunities offered
Review of behavioral health providers’ utilization history will begin February 2020
e-referral upgrades coming in February
Revisions: 2019 third-quarter CPT code updates
Be sure to use our updated Keep office information secure flyer
Save time, submit prior authorization requests electronically for pharmacy benefit drugs
Get ready for annual visits for your MA patients
Balance billing allowed for nonstandard hearing aids
Drugs to treat members with opioid use disorder and behavioral health conditions now payable in home or AICs
New program to streamline medical record request process starts Jan. 1, 2020
Consider an ASC as a site-of-care option for low-risk patients
Blue Cross updates its concierge medicine policy
Register for webinar about hyaluronic acid products for knee injections
Updated e-referral questionnaires coming for BCN and Medicare Plus Blue PPO
Updated Finding your plans and networks guide now available
Updating changes to your Provider Authorization form
Here are FEP benefit changes for 2020
All Providers
Facility
Pharmacy

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2019 American Medical Association. All rights reserved.

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