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Provider Central

JUNE 2022

About the News Recap

We send this Recap monthly 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

Enhanced claim edits for modifiers

Effective July 18, 2022, we will enhance our claims editing system to improve its overall accuracy regarding modifier usage.

Reminder: Bill outpatient rehab services per our payment policy

As a reminder, Blue Cross reimburses for outpatient rehabilitation services as outlined in our existing Outpatient Rehabilitation Services payment policy.

Updated payment policies now available

A detailed list of our payment policies updated in Q2 2022 that is now available on Provider Central.

Clinical & Pharmacy

Are you collaborating with mental health providers?

Studies have shown that a comprehensive approach to care, one that addresses both medical and mental health, leads to better outcomes and an improved patient experience.

Prior authorization for Rx infant formula suspended until Aug 18

Due to the current supply chain issues affecting infant formula nationwide, the Division of Insurance has instructed insurers to relax prior authorization requirements for prescription infant formula for 90 days.

Reduce COPD care disparity: Check Rx after discharge

If your patient with COPD has gone to the emergency room or has had an inpatient stay due to an exacerbation, follow up with them to ensure they understand how and when to take their medications.

Reproductive health travel benefit

In response to today’s Supreme Court decision in the case of Dobbs vs. Jackson Women’s Health Organization, Blue Cross Blue Shield of Massachusetts released a statement.

September 2022 Medical and Pharmacy Policy updates now available

Lists of new, revised, and clarified medical policies and pharmacy medical policies effective in September 2022 are now available.

Office Support

Claim submission in Online Services ends on July 22

If you currently use Online Services to submit 1500 claims using Direct Data Entry, you will need to begin using ConnectCenter by July 22. Online Services will be retired for all transactions on August 12.

ConnectCenter Tips: Benefits information

You can use ConnectCenter to check benefits and eligibility for Massachusetts, out-of-state, Federal Employee Program, and international Blue Cross Blue Shield members.

ConnectCenter Tips: Patient information

Every time you check a member’s eligibility status in ConnectCenter, the results are stored in your Eligibility History.

Make sure you're receiving our emails

Please check your junk or spam folder to ensure that our emails are delivered to your inbox.

Our members want to find you

Please review and update your provider directory information. The Consolidated Appropriations Act (CAA) requires provider directory information to be verified every 90 days.

Prepare for ConnectCenter transition

You'll need to transition from Online Services to ConnectCenter for claims submission by July 22, and for real time transactions (eligibility and claim status) by August 12.

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
June 1	PT, OT, ST update: Multiple procedure payment reduction (MPPR)
June 1	Mental health providers can now be reimbursed for supervision
June 1	Fee schedule updates for September 1, 2022
June 1	New codes added to Outpatient and Surgical Day Care list
June 30	We updated our behavioral health fee schedules

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Blue Cross Blue Shield of Massachusetts refers to Blue Cross and Blue Shield of Massachusetts, Inc., Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc., and/or Massachusetts Benefit Administrators LLC, based on Product participation.® Registered Marks of the Blue Cross and Blue Shield Association.®″Registered mark is the property of its respective owner.© 2022 Blue Cross and Blue Shield of Massachusetts, Inc., or Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc.