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June 2024
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Here’s how medical residents can join our network
Medical residents interested in joining our network can submit their Blue Cross Blue Shield of Michigan or Blue Care Network provider enrollment applications up to 60 days before they complete their training. Read more.


Inside this issue for you

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See all the articles in this issue, grouped by category, below.
Professional
Talk to Medicare Advantage members about how to maintain independence and confidence
We invite you to join PGIP as a physician organization
Blue Cross, BCN to begin reimbursing E/M when billed with preventive service
Save time by submitting only required information about acute inpatient medical, surgical admissions
AllianceRx Walgreens to become exclusive specialty drug pharmacy for MESSA, starting July 1, 2024
Guidelines for using Autism diagnostic evaluation results form
Cancer screening resources to share with patients
Webinars for physicians, coders focus on risk adjustment, coding
We’ve enhanced the Authorizations & Referrals tool in Availity Essentials
No application necessary for certain specialties to join BlueHPN
Change to prior authorization process for Blue Cross commercial members in Michigan whose plans have local provider networks
New webpage provides Medicare Advantage prior authorization clinical review criteria in one convenient location
Additional drugs to have a site-of-care requirement for some commercial members, starting Aug. 1
Amtagvi has additional requirements for most commercial members
We’re granting a 90-day extension to the time limit for commercial claim submission
Clinical editing policies updated
Omvoh SC and IV to have step therapy requirement for most commercial members
Select Medicare Advantage members will receive Cologuard test kit in June
Cosentyx IV to have a site-of-care requirement for most commercial members, starting July 1
Pemfexy and Pemrydi RTU to have additional step therapy requirements for most members
Spevigo SC now has requirements for most commercial members
Change coming to nonclinical, transitional care program through Home & Community Care
TurningPoint opens peer-to-peer reviews to advanced practice providers for musculoskeletal, pain management procedures
Register now for 2024 virtual provider symposium sessions
Vyjuvek now has site-of-care requirement for most commercial members
All Providers
Facility
Save time by submitting only required information about acute inpatient medical, surgical admissions
AllianceRx Walgreens to become exclusive specialty drug pharmacy for MESSA, starting July 1, 2024
Guidelines for using Autism diagnostic evaluation results form
Webinars for physicians, coders focus on risk adjustment, coding
Here’s what you need to know about the proposed ambulance purchased services program and how to provide feedback
We’ve enhanced the Authorizations & Referrals tool in Availity Essentials
No application necessary for certain specialties to join BlueHPN
Change to prior authorization process for Blue Cross commercial members in Michigan whose plans have local provider networks
Additional drugs to have a site-of-care requirement for some commercial members, starting Aug. 1
Amtagvi has additional requirements for most commercial members
We’re granting a 90-day extension to the time limit for commercial claim submission
Clinical editing policies updated
Vendor change for commercial DRG audits beginning June 2024
Emergency Department Claim Analyzer reminder and reconsideration program
Omvoh SC and IV to have step therapy requirement for most commercial members
Select Medicare Advantage members will receive Cologuard test kit in June
Cosentyx IV to have a site-of-care requirement for most commercial members, starting July 1
Pemfexy and Pemrydi RTU to have additional step therapy requirements for most members
Spevigo SC now has requirements for most commercial members
Change coming to nonclinical, transitional care program through Home & Community Care
TurningPoint opens peer-to-peer reviews to advanced practice providers for musculoskeletal, pain management procedures
Register now for 2024 virtual provider symposium sessions
Vyjuvek now has site-of-care requirement for most commercial members
For BCN news and information, see the current issue of BCN Provider News.

For news and information about our strategic goals and initiatives, see the current issue of Hospital and Physician Update.

To subscribe to any of our newsletters for health care providers, click here.

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