Georgia
Provider Communications

June 2018 BCBSGa Provider Newsletter

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Title Category

2018 BCBSGa Provider Town Hall meeting schedule update

Administrative

6/01/18 Notification of Preapproval List Changes (Including Non-AIM and moving to AIM)

Policy Updates

Ambulatory Surgery Center Services and Publix Members

Administrative

Availity is now our designated EDI Gateway

Administrative

Availity Webinar Schedule

Administrative

BCBSGa Adopts MCG Care Guidelines for Behavioral Health Services

Policy Updates

BCBSGa expands Specialty Pharmacy Clinical Site of Care (Level of Care) drug list

Products & Programs

BCBSGa expands specialty pharmacy prior authorization list

Pharmacy

BCBSGa’s Individualized Care Program to support palliative care for commercial members

Products & Programs

Clinical Practice and Preventive Health guidelines available on the web

Administrative

Cologuard covered for Medicare Advantage

Medicare

Coverage Guideline not implemented - Cervical Cancer Screening Using Cytology and Human Papillomavirus Testing (CG-MED-53)

Policy Updates

Keep up with Medicare news

Medicare

MA home health network to be delegated to myNEXUS

Medicare

Medical Policy and Clinical Guideline Updates 4/1/2018

Policy Updates

Medication adherence incentive offered to EPHC providers

Medicare

Motion Picture Industry Pension and Health Plans Offers Medicare Advantage Option

Medicare

Peer-to-peer process can help clarify clinical record

Medicare

Pharmacy information available on anthem.com

Pharmacy

Receive Direct Deposit of Patient Payments with Healthcare Bill Payments

Administrative

Reimbursement Policy Reminder - Durable Medical Equipment (Professional)

Policy Updates

Reimbursement Policy Update - New Pharmaceutical Waste Facility Reimbursement Policy effective September 1, 2018 – Facility

Policy Updates

Reimbursement Policy Update – Diagnosis-Related Group Newborn Inpatient Stays (Facility)

Policy Updates

Reminder – Miscellaneous durable medical equipment billing guidelines

Administrative

Reminder: BCBSGa accepts prior authorization requests for prescription medications online

Pharmacy

Review of Reimbursement Policies – Professional

Policy Updates

Update to claim processing for services requiring AIM prior authorization

Products & Programs

Updates to AIM Musculoskeletal Program Clinical Appropriateness Guidelines

Policy Updates

Verifying eligibility for expanded hospice benefits

Administrative
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