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Provider Central

MARCH 2022

 
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About the News Recap

 

We send this Recap each month to summarize news published on Provider Central. You can click the article headline to view it on Provider Central, the red icon to download a PDF, or the envelope to forward via email.

Claims, Coding, Payment
Continuous passive motion devices
As a reminder, Blue Cross covers continuous passive motion devices as described in Continuous Passive Motion in the Home Setting medical policy 407. The medical policy describes conditions that must be met for the device to be covered for our commercial and Medicare Advantage members.
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Medicare sequestration to resume April 1, 2022
The Protecting Medicare and American Farmers from Sequester Cuts Act will reinstate the Medicare payment adjustment known as “sequestration” effective April 1, 2022.
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Reminder: Bill E/M services with professional revenue codes
As a reminder, we only reimburse E/M services in a facility setting when billed with professional revenue codes. In Q2 2022, we will have the ability to process claims in accordance with our payment policy both pre- and post-payment
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Updated payment policies now available
2022 Q1 news article highlighting all of the payment policies that were updated this past quarter.
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Clinical & Pharmacy
Auth requirements and credentialing procedures continue to be relaxed
We continue to waive authorization requirements and expedite credentialing applications through the dates listed in our news article.
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COVID-19 treatments available across Massachusetts
Please ensure that eligible patients have access to COVID-19 therapies as soon as possible. Supply limitations are not a barrier for treatment, according to the Massachusetts Department of Public Health.
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June 2022 Medical and Pharmacy Policy updates now available
Lists of new, revised, and clarified medical policies and pharmacy medical policies effective in June 2022 are now available.
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Metro Drugs to leave fertility specialty pharmacy network May 1
Blue Cross Blue Shield of Massachusetts announced that members can now visit a preferred pharmacy or use mail order to get authorized COVID-19 at-home tests for $0.
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Office Support
It’s time to review your directory information
Provider directories are important to helping patients find the care they need. Therefore, it’s important you keep your directory information accurate and up to date. Please take the time now to review your directory information.
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We no longer provider claim status to non-participating providers
Starting March 14, 2022, non-participating (non-contracted) providers will no longer be able to obtain claim status by calling Provider Service.
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News Alerts
Our secure website also includes News Alerts specific to your type and specialty. Below we listed all News Alerts published this month. These may or may not apply to your provider type. To read News Alerts specific to your provider type and specialty, log on to bluecrossma.com/provider and click News. Look for the red exclamation point.
 
Date published News Alert
March 1 Pharmacy benefit and medical policy updates