04/03/2018

BCBSM/BCN

Recent Oncology Related News

Provided by MSHO Managed Care Committee Members:

April 26, 2018, ICT Webinar: You’ve submitted a few claims; now what?

Have you submitted a few claims, but need help with the next step? If so, join us for an Internet Claim Tool webinar on Thursday, April 26, 2018, from 10 a.m. to 11 a.m. This webinar is designed for new professional ICT users. We will focus on how to assign claims to a new payer; the Payer Response Report; viewing transmitted claims; and resending edited claims. Please note attendees should have already submitted claims; this session is not intended as a first-time user’s tutorial.

If you would like to participate, please send an email with your first and last name, web-DENIS ID, company name, billing NPI and unique email address information to edicustmgmt@bcbsm.com. We will supply login details prior to the training session. 

EDI Customer Management

Delayed Medicare Advantage 835 remittance files

Blue Cross Blue Shield of Michigan has not received Medicare Advantage 835s for check date April 03, 2018. We are working with Medicare Advantage to obtain the files. All files will be distributed upon receipt.

We apologize for any inconvenience.

Earn continuing education credit by attending a provider forum

Blue Cross Blue Shield of Michigan and Blue Care Network's 2018 provider forums begin in May. You can register for the full day or choose to attend just the morning or afternoon session. Dates, times, locations and registration information can be found on our provider forum flyer (PDF). More information is available in the March issue of The Record.

Blue Cross to update ClaimsXten^TM with additional professional and outpatient facility edits in June

Starting in June 2018, Blue Cross will update ClaimsXten to edit additional professional and outpatient services. These new edits will promote correct coding and simplify our claims payment systems.

• New patient services that are billed for established patients by professional providers within the established timeframes will deny for correct established patient code.
• Anesthesia services reported with non-anesthesia codes that are not eligible to be reported for anesthesia providers will deny for resubmission with the correct anesthesia code.
• Procedures that allow global component billing that are reported by more than one provider for the same component will deny. Blue Cross payment policy only pays up to the global component fee.
• Claim lines with services considered unbundled according to CMS National Correct Coding Initiative will deny. Unbundled services are not recommended for reimbursement.

Additional reminders of these new ClaimsXten edits will be published in future web-DENIS and  Record articles.

April 2018 – Issue

• PGIP allocation amount to increase for most codes
• Blue Cross changing practitioner fees July 1
• New opportunities for CQI value-based reimbursement: Find out how to become eligible
• What you need to know about Blue Cross

CHECK OUT THESE ARTICLES AND MUCH MORE HERE!