Georgia
Provider Communications

October 2018 BCBSGa Provider Newsletter

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Title Category

Reminder to use Laboratory Corporation of America

Administrative

Special Investigations Unit updates

Administrative

Availity EDI Gateway webinars scheduled

Administrative

New operating system changes

Administrative

BCBSGa and Availity have partnered to operate the EDI Gateway

Administrative

Integrated medical and behavioral healthcare services

Administrative

Refer patients to in-network providers

Administrative

Explore new enhancements to the Education and Reference Center

Administrative

Tips for billing CPT modifier 33

Administrative

Use the Provider Maintenance Form to update your practice information

Administrative

Clinical Practice and Preventive Health guidelines available on the web

Administrative

Notice about the PAR Network

Products & Programs

BCBSGa Community Care Coordination expands relationship with Preferred Community Health Partners to support commercial members with complex needs

Products & Programs

BCBSGa fights opioid addiction: Extension for Community Healthcare Outcomes and Quality Medication-Assisted Therapy

Products & Programs

BCBSGa expands specialty pharmacy prior authorization list

Pharmacy

BCBSGa expands specialty pharmacy clinically equivalent drug list

Pharmacy

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

Pharmacy

Access patient-specific drug benefit information through EMR

Pharmacy

Pharmacy information available on the web

Pharmacy

Update to AIM Specialty Health radiation oncology clinical appropriateness guidelines

Medical Policy & Clinical Guidelines

Update to AIM Specialty Health sleep disorder management clinical appropriateness guidelines

Medical Policy & Clinical Guidelines

Update to AIM Specialty Health clinical appropriateness guidelines: advanced imaging appropriate use criteria: imaging of the heart

Medical Policy & Clinical Guidelines

New reimbursement policy: readmissions (Facility)

Reimbursement Policies

New reimbursement policy: Revenue Code Billing (Facility)

Reimbursement Policies

Claims Requiring Additional Documentation reimbursement policy update (Facility)

Reimbursement Policies

Assistant Surgeon Coding update (professional)

Reimbursement Policies

Documentation and Reporting Guidelines for E/M Services update (professional)

Reimbursement Policies

Routine Obstetrical Services update (professional)

Reimbursement Policies

Notification of preapproval list changes

Policy Updates

Medical policy and clinical guideline updates 10/1/2018

Medical Policy & Clinical Guidelines

Genetic testing prior authorization by ordering physician helps ensure accurate lab payment

Medicare

BCBSGa transitions MA back pain management and cardiology UM programs from OrthoNet to AIM

Medicare

Please evaluate statin use for MA members with diabetes, cardiovascular disease

Medicare

Medicare pharmacy and prescriber home starts January 2019

Medicare

Keep up with Medicare news

Medicare

Health Services must be reported in accordance to Coded Service Identifier guidelines

Administrative

Update to Durable Medical Equipment – effective October 14, 2018

Administrative
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