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Provider Central

JULY 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

Expanding telehealth payment parity for mental health services

Effective for dates of service on or after August 1, when a claim includes a primary/principal diagnosis code only of F01 through F99, we will reimburse telehealth at the same rate as in-person visits for all providers, regardless of specialty.

Third quarter 2022 hospital outpatient drug fee schedule

We updated our commercial HMO, PPO, and Indemnity hospital outpatient fee schedules.

Clinical & Pharmacy

October 2022 Medical and Pharmacy Policy updates now available

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

Office Support

Action required! Online Services is being retired

Online Services users will need to switch to ConnectCenter.

Changes to authorization tools for PT, OT, ST, and home health services

Because you must submit an authorization request—not a referral—for outpatient rehabilitation and home health care, you must begin using Authorization Manager for these services.

ConnectCenter Tips: Claim status inquiries

To help you make the transition to ConnectCenter, here are some tips on how to check the status of your claims using the new portal.

Important: Online Services extension

We are discontinuing the claim submission feature in Online Services on a rolling basis.

Online Services claims and timely filing reports in ConnectCenter

If you submitted claims in Online Services, ConnectCenter’s Customer Portal can provide detail about the status of those claims.

Switch to ConnectCenter today for claims, eligibility, and benefits

If you haven’t already, attend one of the many webinars being offered to support you in this transition.

We’ve made changes to our website

The Medical Policy page on Provider Central is now in the Clinical Resources tab.

Plans & Products

HealthAlliance Home Health & Hospice is leaving our network

HealthAlliance Home Health & Hospice, Inc. is leaving the Blue Cross Blue Shield network as of August 31, 2022. You’ll need to refer new patients to a participating in-network provider for home health and hospice services.

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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.