Encourage Members to Participate in Early Detection Lung Cancer Screening

Annual screening for lung cancer in your patients who have a history of smoking can detect cancer early when it may be simpler to treat. We encourage you to talk with our members about lung cancer risk factors and the importance of regular screening.

EXL Post‑Pay Itemized Bill Reviews Paused as of July 2, 2024

We’ve paused EXL post‑payment itemized bill reviews to evaluate the program. Learn more details of how this impacts your claims.

Procedure Code and Fee Schedule Update

As of Sept. 1, 2024, we updated select codes in the 90630‑90756 and Q2034‑Q2039 Current Procedural Terminology (CPT^®) code ranges.

Shared Decision‑Making Aids Can Help Guide Care Choices

Our members may have better patient experiences and outcomes when they participate in their care. Learn about evidence‑based aids that can help involve your patients.

Catch Up with Our Provider Network Consultants and Hot Topics

Join our PNCs on Sept. 12, 2024, for this month’s Provider Hot Topics webinar. Need a recap of previous webinars? Our PNCs have compiled a list of the top hot topics for this quarter.

Earn Continuing Education Credit at Maternal Mental Health Webinar

On Sept. 9, 2024, we’re offering a free webinar on maternal mental health from 9 to 10 a.m. Register here  and learn more about our behavioral health webinars.

Register for Webinars on Coding for Cancers, Stroke and Heart Failure

Join our Coding Compliance team for webinars in September and October on coding and documentation. The webinars are free to providers and coding professionals, and have tips on closing gaps in care.

Explore More Learning Opportunities

We offer free webinars and workshops for providers who participate in our networks. Sessions include training on electronic tools and orientation webinars for new providers.

Encourage Medicare Members to Respond to Health Outcomes Survey

The Centers for Medicare & Medicaid Services sends a survey to a sample of our members to rate their care. Learn about the survey topics our members may discuss with you.

Members of Other Blues Plans May Access the Blue Choice PPO^SM Network in 2025

Blue Choice PPO will be nationally available as of Jan. 1, 2025. You must participate in the Blue Choice PPO network to be reimbursed as an in‑network provider for members with Blue Cross and Blue Shield of Illinois and other Blues Plans.

Has Your Information Changed? Let Us Know

When seeking health care services, our members often rely on the information in our online Provider Finder^®. Keeping your information updated can help members confirm if your practice is in network for their benefit plan.

Abiraterone Drug Coverage Changes for Many Commercial Members as of Oct. 1, 2024

Starting Oct. 1, 2024, coverage of abiraterone acetate will change for many of our commercial members with pharmacy benefits administered by Prime Therapeutics. These members will only have coverage for the CivicaScript^®‑produced, low‑cost generic version of abiraterone acetate 250 mg.

30‑Day Supply Limit: Select Commercial Members Have New Pharmacy Benefit for GLP‑1 or Anti‑Obesity Drug Therapy

This optional pharmacy benefit program is available to some employer groups with Prime Therapeutics. Learn how it aims to reduce drug waste.

Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2024 – Part 1

Based on the availability of new prescription medications and Prime’s National Pharmacy and Therapeutics Committee’s review of changes in the pharmaceuticals market, some additions, revisions (drugs still covered but moved to a higher out‑of‑pocket payment level) and/or exclusions (drugs no longer covered) were made to our drug lists.