Georgia
Provider Communications

August 2018 BCBSGa Provider Newsletter

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Title Category

2018 BCBSGa provider Town Hall meeting schedule update

Administrative

Additional support available for members with rare conditions

Products & Programs

Archived medical policy

Medical Policy & Clinical Guidelines

Are you looking for innovative ways to improve your patients’ experiences and earn CME credits?

Administrative

Availity is BCBSGa’s designated EDI Gateway

Administrative

BCBSGa accepts prior authorization requests for prescription medications online

Pharmacy

BCBSGa adopts Milliman Care Guidelines for inpatient rehabilitation, subacute rehabilitation and skilled nursing facility clinical reviews

Medicare

BCBSGa applies daily morphine equivalent dosing limit

Pharmacy

BCBSGa engages with Alliant Health Solutions

Administrative

BCBSGa expands specialty pharmacy clinical site of care (level of care) drug list

Pharmacy

BCBSGa expands specialty pharmacy prior authorization list

Pharmacy

BCBSGa to enhance automated claim edits for professional claims

Administrative

BCBSGa to update drug lists supporting commercial health plans

Pharmacy

Care and Cost Finder – new sort option

Administrative

Clinical Practice and Preventive Health guidelines available on the web

Administrative

CMS issues regulatory changes for short- and long-acting narcotics; days’ supply limits effective Jan. 1, 2019

Medicare

DME providers and physicians: important wheelchair prior authorization information

Medicare

Federal Employee Program® (FEP) paper claims and claims related correspondence mailing address

State & Federal

HEDIS® 2018: provider incentive winners announced

Administrative

Important billing update for professional delivery claims

Policy Updates

Important information about billing colonoscopy and related anesthesia services

Administrative

Improved claims escalation process

Administrative

Interactive Care Reviewer (ICR) tool enhancements

Administrative

Introduction to Availity EDI Gateway services for BCBSGa provider organizations

Administrative

Keep up with Medicare news

Medicare

MA members receive incentives for completing screenings

Medicare

Medical policy and clinical guideline updates 8/1/2018

Medical Policy & Clinical Guidelines

Member explanation of benefits gets a makeover

Administrative

MyDiversePatients.com addresses health care disparities

Medicare

MyDiversePatients.com: A website to support your diverse patients

Administrative

New prior authorization requirement for EGD services begins November 1, 2018

Policy Updates

Notification of preapproval list changes 8/1/18

Medical Policy & Clinical Guidelines

Pharmacy information available on the web

Pharmacy

Professional reimbursement policy updates

Reimbursement Policies

Provider transparency update

Administrative

Streamlined workflow for solicited medical attachments

Administrative

Submit clinical information with request

Administrative

Submit PA medication requests electronically; new phone number for MA prescription PAs effective Sept. 1

Medicare

Update to AIM radiation oncology clinical appropriateness guidelines

Policy Updates

Updates to AIM advanced imaging clinical appropriateness guidelines

Policy Updates

Use the Provider Maintenance Form to update your practice information

Administrative

Vaginal birth after cesarean (VBAC) certified shared decision making aid available on the web

Administrative

We’re changing our trade name

Administrative
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