Issue 1, 2010
Medicare Advantage mandatory provider FWA training
All contracting providers (i.e., physician practices, facilities, DME providers, etc.) participating in a Medicare Advantage (Part C) network must complete fraud waste and abuse (FWA) training annually.
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Availity’s new claims research tool offers speed, accuracy
Availity’s online Claims Research Tool provides real-time access to claim status information at no cost to you.
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Reminder! New plan years have begun, verify member ID cards
Make sure you have a copy of your patients’ current ID cards and note the new alpha prefix for some members when submitting claims.
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Newly designed public Web site launched
Our Web site redesign gives patients access to publicly available tools and resources to help them navigate the often complex world of health insurance.
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Important provider information on new wellness initiatives for federal employees under the Service Benefit Plan
Beginning Jan. 1, 2010, the Blue Cross and Blue Shield Service Benefit Plan began rewarding members when they complete either the adult Blue Health Assessment or a child’s body mass index (BMI) assessment.
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Texas amends age limit for autism spectrum disorder benefits
Benefits for generally recognized services prescribed in relation to autism spectrum disorder will be available for members between the ages of birth and 10 years, up from 6 years.
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Medical offices are gaining the paperless advantage …
Sign up today to receive the Electronic Remittance Advice (ERA) and Electronic Payment Summary (EPS).
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Are you using paper claims to bill unlisted procedure codes for drugs and injections?
Review these procedures for including the description of services rendered when billing an unlisted procedure code (NDC number).
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BCBSTX Medicare Part D formulary changes for 2010
See a list of the most popular medications affected by the 2010 Medicare Part D formulary.
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La Cruz Azul and U.S. Virgin Island claims run-out period
Services incurred in Puerto Rico or the U.S. Virgin Islands on or after July 1, 2009 will be processed through BlueCard by Triple-S Management Corporation.
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Medicare Part D pharmacy updates: dose optimization
Dose optimization is simple to implement and well accepted by providers and patients.
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Notices and announcements
Each issue, we publish brief notices and announcements you may need. For the latest updates, visit the What’s New section of our Provider Web site at www.bcbstx.com/provider.
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In every issue
New for 2010, these announcements are important enough to be included in every issue.
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Change your information online
Click the Change Your Information icon at www.bcbstx.com/provider to electronically submit a change to your name, office or payee address, e-mail address, telephone number, tax ID, or other information. You should submit all changes at least 30 days in advance of the effective date of the change.
If your specialty, practice information/status or board certification is not correct on Blue Cross and Blue Shield of Texas (BCBSTX) Provider Finder®, or if you would like to have a subspecialty added, you can enter the information in the Other field or contact your local Professional Provider Network office.
Blue Review is published for BlueChoice®, ParPlan and HMO Blue® Texas contracting physicians and other health care providers. Ideas for articles and letters to the editor are welcome; e-mail BlueReviewEditor@bcbstx.com.
The information provided in Blue Review does not constitute a summary of benefits, and all benefit information should be confirmed or determined by calling the customer service telephone number listed on the back of the member ID card.
BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by independent third-party vendors mentioned in this newsletter. The vendors are solely responsible for the products or services they offer. If you have any questions regarding any of the products or services mentioned in this periodical, you should contact the vendor directly.
