09/15/2025
BCBSM/BCN
Publications
September 2025 Issue Available HERE.
A Few Articles You Will Want to Check Out:
- Recent amendment to CNP, PA contracts allows them to participate in certain PGIP incentive programs
- Blue Cross, BCN are contacting providers about appointment access standards
- Webinars for physicians, coders focus on documentation, coding
- Pharmacy news roundup
- We renamed the tile for the Medical and Pharmacy Drug PA Portal for commercial members
- Billing chart: Blue Cross highlights medical, benefit policy changes
- Behavioral Health Incentive Program ending after Dec. 31, 2025
September/October Bi-Monthly Issue Available HERE.
A Few Articles You Will Want to Check Out:
- New Provider Prior Authorizations website coming soon (Page 2)
- Return signed contracts for BCN commercial network affiliation or MCG affiliation through DocuSign within 14 calendar days (Page 4)
- Reminder: Participating providers may only collect applicable deductibles, copayments from members upfront (Page 5)
- Recorded webinar for providers, office staff focuses on prior authorization best practices (Page 6)
- Webinars for physicians, coders focus on documentation, coding (Page 7)
- Be aware of Medicare fraud scheme involving phishing requests by fax and other means (Page 8)
- Patient Experience: Understanding the importance of the “Getting Needed Care” domain in CG-CAHPS (Page 15)
- Medical policy updates (Page 16)
- BCN updates behavioral health fee schedule effective July 1 (Page 17)
- Pharmacy news roundup (Page 20)
- Yesintek to have a site-of-care requirement for most commercial members, starting Sept. 1 (Page 21)
- Submit clinical documentation through Medical and Pharmacy Drug PA Portal (Page 22)
- Update: Medicare Advantage prior authorization requests submitted through NovoLogix must be submitted through different application (Page 24)
- Starting Sept. 1, we’ll change how we pay for certain medications for most Blue Cross and BCN commercial members (Page 26)
- Coding corner: Morbid obesity and its connection to risk adjustments (Page 27)
- Reminder: Follow these requirements when billing for noncovered services (Page 29)
- Follow these guidelines when billing for remote patient monitoring (Page 29)
- CPT II coding (Page 31)
- Clinical editing updates (Page 32)
- We’re changing how we manage self-administered hemophilia products for most Blue Cross, BCN commercial members, starting Sept. 1 (Page 37)