News and Updates

Legislative Changes

Provider Information on COVID-19 Coverage

Blue Review

12/20/24 PEAQ^SM Program Adds New Specialties for Cost Efficiency Analysis
12/19/24 Records Needed to Support Quality Care for Medicare Advantage Members
12/19/24 Ensure Your Office Is Providing Your Most Current Information
12/18/24 Medical Records Collection for Federal Employee Program^® Begins in February
12/17/24 Prior Authorization Code Updates for Medicare Advantage Effective April 1, 2025
12/17/24 Prior Authorization Codes Updated for Commercial Members Effective April 1, 2025
12/13/24 Remind Billing Agencies to Correctly Submit Claim Review Requests
12/12/24 Follow-Up Care Is Recommended for Children Prescribed ADHD Medication
12/10/24 ClaimsXten™ Quarterly Update Effective March 17, 2025
12/09/24 Solutions and Results Monitoring for Gene Therapy Treatments to Launch in 2025
12/06/24 Medicare Providers May Treat Blue Cross Group Medicare Advantage Open Access (PPO)^SM Members
12/05/24 Remind Our Members about Cervical and Breast Cancer Screenings
12/04/24 Medicare-Like Rates to Apply to Claims for Some Self-Funded Tribal Plans
12/04/24 CMS Tracks High-Risk Medication Combinations with New Part D Quality Measures
12/03/24 Keep Your Contact Information Updated to Receive Recredentialing Reminders
11/26/24 Funds to Be Recouped on Some Medicare Advantage Hospital and Ancillary Claims
11/22/24 Preferred Drugs to be Recommended Through Enhanced Prior Authorization
11/19/24 Technology May Help Increase Engagement with Your Patients
11/18/24 Coding Reference for Quality Measures Is Available to Help Identify Gaps in Care
11/13/24 Cultural Awareness Webinars: No-Cost Continuing Education Credit
11/12/24 Follow Centers for Medicare & Medicaid Services Guidelines for Appointment Wait Time Standards
11/07/24 Oklahoma Senate Bill 1739 Impacts Licensing and Provider Types for Birthing Centers
11/06/24 Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2025 – Part 1
11/01/24 Prior Authorization Code Updates for Medicare Advantage Effective Jan. 1, 2025
10/29/24 How to Submit Photos to Accompany Prior Authorization or Recommended Clinical Review Requests
10/28/24 Out-of-State Care Beyond Contiguous Counties No Longer Covered Benefit
10/24/24 Code Effectively to Earn Additional Incentive Payments on Medicare Advantage Claims
10/23/24 Talk to Our Members About the Flu Vaccine
10/18/24 Members Value Open Communication from Their Providers
10/17/24 Update: Select Self-Administered Drugs Moving to Pharmacy Benefit Effective Mar. 1, 2025
10/16/24 Encourage Annual Eye Exams for Our Members with Diabetes
10/16/24 Statin Therapy Is Recommended for Patients with Cardiovascular Disease and Diabetes
10/15/24 Medicare Prescription Payment Plan Launching Jan. 1, 2025
10/10/24 Care Coordination Can Help Our Members After Hospital Discharges
10/08/24 Risk Identification and Outreach Program Supports Member Safety
10/02/24 Reminder: 2024 Provider Access and Appointment Availability Survey
10/02/24 Acquisition of Cigna Healthcare Medicare Business in 2025
10/01/24 Check ID Cards for New Coupe Health Plan Members
10/01/24 Updates Coming to Behavioral Health Substance Abuse Criteria for Utilization Management
09/30/24 Prior Authorization Codes Updated for Commercial Members Effective Jan. 1
09/27/24 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2024 – Part 2
09/26/24 Utilization Management Review Expanding for Advanced Imaging for Some Commercial Members Jan. 1, 2025
09/20/24 Learn What Members Say They Want from Their Health Care Professionals
09/13/24 Register for a Coding Webinar on Coagulation Defects and Other Hematological Disorders
09/10/24 Breast Cancer Screening Begins at Age 40
09/09/24 ClaimsXten™ Quarterly Update Effective Dec. 9, 2024
09/09/24 Reminder: Submit Paper Commercial Claims to Correct PO Box to Avoid Delays
09/09/24 In-home Test Kits Help Our Members Manage Their Kidney Health
09/05/24 Closing Care Gaps in Child and Adolescent Weight Assessment and Nutrition Counseling
09/04/24 Use the Updated Claims Referral Form for American Indian/Alaska Native Limited Cost Share Plans
08/22/24 Watch for our Provider Advisory Survey
08/16/24 Revised Effective Date: Reimbursement Change for Consultation Services, Now Nov. 18, 2024
08/15/24 Physician Performance Insights Reports Are Now Available
08/15/24 Shared Decision-Making Aids Can Help Guide Care Choices
08/14/24 Register for Webinars on Coding for Stroke, Cancers and Heart Failure
08/13/24 Check Member ID Cards for New Coupe Health Plan Members
08/12/24 30-Day Supply Limit: Select Commercial Members Have New Pharmacy Benefit for GLP-1 and/or Anti-Obesity Drug Therapy
08/08/24 Encourage Medicare Members to Respond to Health Outcomes Survey
08/01/24 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2024 – Part 1
08/01/24 Reminder: Statewide Fee Schedule Update
07/23/24 Provider Finder^® to Rank Providers to Help PPO Members Find Care
07/22/24 Medicare Providers May Treat Blue Cross Group Medicare Advantage Open Access (PPO)^SM Members
07/16/24 Has Your Information Changed? Update Us and the NPI Registry
07/16/24 Check Prior Authorization Requirements for Procedure Codes through Availity^® Essentials or Our IVR System
07/08/24 Coming Soon: 2024 Provider Availability and Access Survey
07/03/24 Earn Continuing Education Credit: Webinar on Avoiding Inappropriate Antibiotic Use
06/26/24 Pharmacy Program Quarterly Update – Part 2 Changes Effective July 1, 2024
06/26/24 Physician Performance Insights Reports Coming Soon from PEAQ^SM
06/26/24 Prior Authorization code updates for Medicare Advantage Effective Oct. 1
06/26/24 Prior Authorization Codes Updated for Commercial Members Effective Oct. 1
06/26/24 Proper Billing for Supplies for Transcutaneous Electrical Nerve Stimulation Units
06/24/24 New Coupe Health Plan: Update Your Member Records
06/20/24 Coming Soon – New Learning & Training Center in Availity^® Essentials
06/07/24 Provider Rights and Responsibilities
06/07/24 Member Rights and Responsibilities
06/07/24 Encourage Routine Vaccines and Well-Care Visits for Children and Teens
06/07/24 In-Home Test Kits for Colorectal Cancer Screening
06/06/24 GLP-1 New to Therapy Optional Benefit Program Available for Select Commercial Members
06/06/24 Reminder: Provider Satisfaction Survey 2024
05/31/24 Cultural Awareness Webinars: No-Cost Continuing Education Credit
05/31/24 Prior Authorization Requests May Be Needed Due to Pharmacy Claims Processing Error
05/31/24 Update: Our Revised Clinical Payment and Coding Policy for Anesthesia Services now Effective Aug. 14, 2024
05/28/24 Updated PEAQ^SM Methodology Is Now Available
05/22/24 Earn Continuing Education Credit: Webinar on Trauma-Informed Care
05/17/24 New: Access MCG Care Guidelines Clinical Criteria via Availity^®
05/08/24 Location Requests Now Only Accepted Through the Demographic Change Form
05/07/24 Behavioral Health Consultations During Hospitalization Can Improve Outcomes
05/07/24 ClaimsXten™ Quarterly Update Effective Aug. 19, 2024
05/06/24 Closing Gaps in Care for Group Medicare Advantage (PPO) members
05/03/24 Reminder: Use New Mailing Address for Paper Commercial Claims to Avoid Mail Delays
05/03/24 Pharmacy Program Quarterly Update Changes Effective July 1, 2024 – Part 1
05/03/24 Helping Our Members Manage Diabetes
04/29/24 Electronic Claim Review and Ensuring the Correct Use of our Claim Review Form
04/17/24 Important Updates to Manage My Organization in Availity^® Essentials
04/16/24 Coding Webinars
04/08/24 Know the Importance of Care Coordination
04/02/24 Supporting Maternal Quality Care
03/28/24 Pharmacy Program Quarterly Update Changes Effective April 1, 2024 – Part 2
03/26/24 Filing Claims for Behavioral Health Services – Use the Correct Place of Service Code
03/26/24 Prior Authorization Codes Updated for Commercial Members
03/25/24 Late and added charges must be submitted as a Corrected Claim
03/12/24 Prior Authorization code updates for Medicare Advantage
03/11/24 Earn Continuing Education Credit: Webinar on Substance Use Disorder
03/06/24 Webinar on Coding for Medicare Advantage Annual Wellness Visits
03/06/24 ClaimsXten™ Quarterly Update Effective June 17, 2024
03/04/24 Caring for Substance Use Disorders
03/01/24 Change Healthcare Cybersecurity Incident Impact and Options
02/26/24 Use the NDC Units Calculator Available in Availity^®Essentials
02/23/24 See Our Revised Clinical Payment and Coding Policy for Anesthesia Services
02/19/24 Earn Continuing Education Credit: Webinar on Social Determinants of Mental Health Care
02/15/24 The Importance of Updating Provider Demographics
02/14/24 30-Day Facility Readmission Reviews for Medicare Advantage Members
02/07/24 Closing Gaps in Colon Care
02/06/24 Federal Employee Program (FEP) Updates to Prior Approval Requirements and Benefits
02/06/24 Pharmacy Program Quarterly Update Changes Effective April 1, 2024 – Part 1
02/05/24 Avoiding the Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
02/02/24 Follow-up Care for Mental Health
02/01/24 Reminder: Update Your Records with New Mailing Address for Paper Commercial Claims and Inquiries
01/24/24 Medicare Advantage HEDIS Records Collection through June 2024
01/19/24 Earn Continuing Education Credit at Webinar on Pediatric Behavioral Health
01/17/24 Changes to Claim Inquiry Resolution– High-Dollar, Pre-Pay Reviews Only
01/16/24 Blue Cross and Blue Shield Federal Employee Program^® HEDIS^® Records: Collecting February through April 2024
01/11/24 Pharmacy Program Quarterly Update: Changes Effective Jan. 1, 2024 – Part 2
01/08/24 ClaimsXten™ Quarterly Update Effective April 15, 2024
01/08/24 Supporting Healthy Hearts
01/05/24 Managing Antidepressant Medication
01/04/24 Annual Medical Record Data Collection for HEDIS Quality Reporting begins Feb. 1