Blue Review - April 2021 | view in Web Browser
A newsletter for contracting institutional and professional providers |
April 2021
What’s New
Free Vaccine Confidence and Process Improvement Webinars for Providers
Register today for our upcoming free Blue UniversitySM virtual events for providers: What is Vaccine Confidence? and Implementation Science: A Discussion on Vaccine Process Improvement. All providers that are independently contracted with Blue Cross and Blue Shield of Illinois (BCBSIL) are welcome to attend. Read more on News and Updates.
Visual Impairment on the Rise: Why This Matters
In our annual Blue Review readership survey, some readers asked for more articles on specialty areas. In response, we’ve created a series of articles on vision impairment.
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Provider Education
BCCHPSM and MMAI Provider Alert: 2020 Mandatory Annual Training Must Be Completed by May 1, 2021
If you provide care and services to our Blue Cross Community Health PlansSM (BCCHP) and/or Blue Cross Community MMAI (Medicare-Medicaid Plan)SM members, but you missed the 2020 training deadline due to COVID 19 challenges, take note! We’ve extended the deadline to May 1, 2021 – and you can complete your training by attending a webinar on April 15.
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Provider Learning Opportunities
BCBSIL offers free webinars and workshops for the independently contracted providers who work with us. A preview of upcoming training sessions is included in this month’s issue.
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Clinical Updates, Resources and Reminders
When and How to Use Our Medical Policy Reference List
Checking eligibility and benefits confirms if prior authorization or pre-notification are required. But how do you know when to submit a voluntary predetermination request prior to rendering services for our commercial, non-HMO members? Our Medical Policy Reference List can help!
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Reminder: Hospital Administrative Days May Be Covered for Medicaid Members
BCBSIL will provide reimbursement for authorized inpatient stays extended beyond medical necessity, also known as Administrative Days (ADs), for some BCCHP and MMAI members for dates of service on or after July 1, 2019.
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Electronic Options
Single Online Access Point for EFT and ERA Enrollments, Effective May 3, 2021
Starting May 3, 2021, BCBSIL will offer a single access point for enrollment in Electronic Funds Transfer (835 EFT) and/or Electronic Remittance Advice (835 ERA) via the Transaction Enrollment tool on the Availity® Provider Portal.
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Pharmacy Program
Specialty Pharmacy Update: Changes to Select Medication List, Effective June 1, 2021
Choosing a drug from our Select Medication List and billing for it with the appropriate National Drug Code (NDC) may result in a higher reimbursement rate than the rate applied for other, non-listed drugs in the same class.
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Claims and Coding
Medicaid Billing Reminders for Home and Community Based Services (HCBS) Waiver Providers
This article applies to HCBS providers – Illinois Department of Healthcare and Family Services (HFS) types 90, 92, 93 and 98 – who submit claims to BCBSIL for our BCCHP and MMAI members.
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Focus on Behavioral Health
Applied Behavior Analysis May Be Covered for Some Medicaid Members with Autism Spectrum Disorder
Effective Nov. 1, 2020, HFS began covering Applied Behavior Analysis (ABA) services for children age 0 through 20 years old and diagnosed with an autism spectrum disorder.
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Community Involvement
Free Programs for BCBSIL Members and Non-members at Blue Door Neighborhood CenterSM
Encourage your patients to attend the free Mental Health Awareness and Women’s Health Month events at our Blue Door Neighborhood Center (BDNCSM).
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CMO Perspective
New Programs Aim to Reduce Disparities and Expand Care Access for Expectant Mothers and Babies
In this month’s CMO Perspective, our Vice President and Chief Medical Officer, Dr. Derek J. Robinson, M.D., MBA, FACEP, CHCQM, talks about new BCBSIL resources to help improve the health outcomes of pregnant women and their infants in underserved communities across Illinois.
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Wellness and Member Education
Help Close the Disparity Gap For Black Women and Breast Cancer
Breast cancer is one of the most common cancers among American women. While breast cancer is most prevalent in white women, Black women have a higher mortality rate.
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Quality Improvement and Reporting
Blood Pressure Control: Speaking Out About the ‘Silent Killer’
Are your patients aware that high blood pressure, or hypertension, is known as a silent killer because it usually has no warning signs?
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Notification and Disclosure
Important Dates and Reminders
Check here each month for a quick snapshot of recent implementations, upcoming changes, special events, important deadlines and other reminders.
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Stay informed! Watch the News and Updates on our Provider website for important announcements. Update Your Information Do you need to update your location, phone number, email or other important details on file with BCBSIL? Use our online forms to request an information change. Provider Training For dates, times and online registration, visit the Webinars and Workshops page. |
Quick Reminders
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