News and Updates
- 12/26/24 Pharmacy Program Updates: Prior Authorization Changes Effective March 1, 2025
- 12/20/24 PEAQSM Program Adds New Specialties for Cost Efficiency Analysis
- 12/19/24 Records Needed to Support Quality Care for Medicare Advantage Members
- 12/19/24 Ensure Your Office Is Providing Your Most Current Information
- 12/19/24 Equal Hope to Reach Out to Members of Blue Cross Community Health PlansSM and Providers
- 12/18/24 Medical Records Collection for Federal Employee Program® Begins in February
- 12/17/24 Prior Authorization Changes for Government Programs Effective April 1, 2025
- 12/17/24 Prior Authorization Changes for Some Commercial Members, Effective April 1, 2025
- 12/13/24 Remind Billing Agencies to Correctly Submit Claim Reviews
- 12/12/24 Follow-Up Care Is Recommended for Children Prescribed ADHD Medication
- 12/10/24 ClaimsXtenTM Quarterly Update Effective March 17, 2025
- 12/09/24 Solutions and Results Monitoring for Gene Therapy Treatments to Launch in 2025
- 12/06/24 Update Your Records for New Blue Cross Medicare Advantage Open Access (PPO)SM Members
- 12/05/24 Remind Our Members about Cervical and Breast Cancer Screenings
- 12/04/24 Illinois Medicaid Providers: Update Your Information in the IMPACT System
- 12/04/24 CMS Tracks High-Risk Medication Combinations with New Part D Quality Measures
- 12/03/24 Keep Your Contact Information Updated to Receive Recredentialing Reminders
- 12/03/24 Blue Choice Options PPOSM Offers Tiered Benefit Levels
- 11/26/24 Funds to Be Recouped on Some Medicare Advantage Hospital and Ancillary Claims
- 11/22/24 Preferred Drugs to be Recommended Through Enhanced Prior Authorization
- 11/21/24 Catch Up with Our Provider Network Consultants and Hot Topics
- 11/20/24 Avoid Many Denials of Long-Term Care Claims with Help From a New Resource
- 11/19/24 Contracted Independent Labs: We May Be Contacting You to Initiate the Credentialing Process
- 11/18/24 Coding Reference for Quality Measures Is Available to Help Identify Gaps in Care
- 11/13/24 Cultural Awareness Webinars: No-Cost Continuing Education Credit
- 11/12/24 Follow Centers for Medicare & Medicaid Services Guidelines for Appointment Wait Time Standards
- 11/12/24 Pharmacy Program Updates: Prior Authorization Changes Effective Jan. 15, 2025
- 11/11/24 Fighting Fraud, Waste and Abuse Reminder: Billing Guidelines for Laboratory Claims
- 11/06/24 Quarterly Pharmacy Changes - Effective Jan. 1, 2025 Part 1
- 11/01/24 Prior Authorization Changes for Government Programs Effective Jan. 1, 2025
- 10/30/24 Pharmacy Program Updates: Prior Authorization Changes Effective Jan. 1, 2025
- 10/29/24 How to Submit Photos to Support Prior Authorization or Recommended Clinical Review Requests
- 10/29/24 Join the Birth Equity Symposium at the Blue Door Neighborhood CenterSM
- 10/28/24 Follow Timely Filing Requirements to Enable Claim Processing and Payment
- 10/24/24 Code Effectively to Earn Additional Incentive Payments on Medicare Advantage Claims
- 10/23/24 Illinois House Bill 2847 (Public Act 103-0535) Requires Coverage of No-Cost Mental Health Preventive and Wellness Visits
- 10/23/24 Talk to Our Members About the Flu Vaccine
- 10/18/24 Join Us At Our Fourth Quarter Professional Provider Forum
- 10/17/24 Update: Select Self-Administered Drugs Moving to Pharmacy Benefit Effective Mar. 1, 2025
- 10/16/24 Encourage Annual Eye Exams for Our Members with Diabetes
- 10/15/24 Statin Therapy Is Recommended for Patients with Cardiovascular Disease and Diabetes
- 10/15/24 Medicare Prescription Payment Plan Launching Jan. 1, 2025
- 10/11/24 Free Programming at Blue Door Neighborhood CenterSM
- 10/10/24 Care Coordination Can Help Our Members After Hospital Discharges
- 10/08/24 Risk Identification and Outreach Program Supports Member Safety
- 10/02/24 Acquisition of Cigna Healthcare Medicare Business in 2025
- 10/01/24 Check ID Cards for New Coupe Health Plan Members
- 10/01/24 Updates Coming to Behavioral Health Substance Abuse Criteria for Utilization Management
- 10/01/24 Out-of-State Care Beyond Contiguous Counties No Longer Covered Benefit
- 10/01/24 Procedure Code and Fee Schedule Updates
- 09/30/24 Prior Authorization Requirement Changes for Some Commercial Members, Effective Jan. 1
- 09/27/24 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2024 – Part 2
- 09/26/24 Some Commercial Members Will Receive Vaginal Estrogen Coverage Effective Jan. 1, 2025
- 09/26/24 Utilization Management Review Expanding for Advanced Imaging for Some Commercial Members Jan. 1, 2025
- 09/25/24 Fraud, Waste and Abuse Reminder: Accurately Identify Rendering Provider for Properly Paid Claims
- 09/19/24 Annual Healthcare Effectiveness Data and Information Set (HEDIS®) Reports Are Available
- 09/13/24 Register for a Coding Webinar on Coagulation Defects and Other Hematological Disorders
- 09/12/24 Pharmacy Program Updates: Prior Authorization Changes Effective Nov. 15, 2024
- 09/10/24 Watch for Illinois Medicaid Quality Improvement Program Changes, Effective Jan. 1, 2025
- 09/09/24 ClaimsXten™ Quarterly Update Effective Dec. 9, 2024
- 09/06/24 Illinois Medicaid Providers: Update Your Information in the IMPACT System
- 09/05/24 Closing Care Gaps in Child and Adolescent Weight Assessment and Nutrition Counseling
- 09/04/24 Reminder: Submit Paper Commercial Claims to Correct PO Box to Avoid Delays
- 09/04/24 Use the Updated Claims Referral Form for American Indian/Alaska Native Limited Cost Share Plans
- 09/03/24 Mandatory Medicaid Training: Attend a Webinar to Fulfill Annual Requirements
- 08/30/24 Physician Performance Insights Reports Are Now Available
- 08/22/24 Pharmacy Program Updates: Prior Authorization Changes Effective Nov. 1, 2024
- 08/21/24 Members of Other Blues May Access the Blue Choice PPOSM Network in 2025
- 08/20/24 Has Your Information Changed? Let Us Know
- 08/19/24 Procedure Code and Fee Schedule Updates
- 08/16/24 Catch Up with Our Provider Network Consultants and Hot Topics
- 08/15/24 Shared Decision-Making Aids Can Help Guide Care Choices
- 08/14/24 Register for Webinars on Coding for Stroke, Cancers and Heart Failure
- 08/13/24 Revised Effective Date: Reimbursement Change for Consultation Services, Now Nov. 18, 2024
- 08/13/24 Check Member ID Cards for New Coupe Health Plan Members
- 08/12/24 30-Day Supply Limit: Select Commercial Members Have New Pharmacy Benefit for GLP-1 and/or Anti-Obesity Drug Therapy
- 08/08/24 Critical Incident Form: Updated Contact Information
- 08/08/24 Encourage Medicare Members to Respond to Health Outcomes Survey
- 08/02/24 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2024 – Part 1
- 07/30/24 EXL Post-Pay Itemized Bill Reviews Paused as of July 2
- 07/30/24 Abiraterone Drug Coverage Changes for Many Commercial Members Set for Oct. 1
- 07/26/24 Encourage Members to Participate in Early Detection Lung Cancer Screening
- 07/25/24 Provider Finder® to Rank Providers to Help PPO Members Find Care
- 07/22/24 Physician Performance Insights Reports Coming Soon from PEAQSM
- 07/18/24 Encourage Routine Vaccines and Well-Care Visits for Children and Teens
- 07/17/24 Apply to Join New MyBlue Plus POSSM Network, Launching Jan. 1, 2025
- 07/17/24 Pharmacy Program Updates: Prior Authorization Changes Effective Oct. 1, 2024
- 07/17/24 Check Prior Authorization Requirements for Procedure Codes through Availity® Essentials or Our IVR System
- 07/16/24 Notify Us if You Opt Out of Medicare
- 07/15/24 Medicare Providers May Treat Blue Cross Group Medicare Advantage Open Access (PPO)SM Members
- 07/12/24 BCCHPSM and MMAISM Providers: Join Our Community Stakeholder Committee
- 07/11/24 Has Your Information Changed? Update Us and the NPI Registry
- 07/11/24 Save the Date for Our Third Quarter Professional Provider Forum
- 07/03/24 Earn Continuing Education Credit: Webinar on Avoiding Inappropriate Antibiotic Use
- 07/02/24 Pharmacy Program Quarterly Update: Changes Effective July 1, 2024 – Part 2
- 07/01/24 Proper Billing for Supplies for Transcutaneous Electrical Nerve Stimulation Units
- 07/01/24 Prior Authorization Changes for Government Programs
- 06/28/24 Prior Authorization Requirement Changes for Some Commercial Members, Effective Oct. 1
- 06/28/24 GLP-1 New to Therapy: Optional Benefit Program for Select Commercial Members
- 06/27/24 Cultural Awareness Webinars: No-Cost Continuing Education Credit
- 06/26/24 Provider Rights and Responsibilities
- 06/26/24 Member Rights and Responsibilities
- 06/25/24 In-Home Test Kits for Colorectal Cancer Screening
- 06/24/24 Breast Cancer Screening for Members Ages 40 to 74
- 06/21/24 New Coupe Health Plan: Update Your Member Records
- 06/20/24 Coming Soon – New Learning & Training Center in Availity® Essentials
- 06/18/24 Provider Hot Topics Summary: Second Quarter 2024
- 06/13/24 Behavioral Health Consultations During Hospitalization Can Improve Outcomes
- 06/12/24 Reminder: Use New Mailing Address for Paper Commercial Claims to Avoid Mail Delays
- 06/12/24 Medicaid Update: Pharmacy Appeals Transition Reminder
- 06/10/24 Pharmacy Program Updates: Prior Authorization Changes Effective Sept. 1, 2024
- 05/31/24 Update: See Our Revised Clinical Payment and Coding Policy for Anesthesia Services, Effective Aug. 14, 2024
- 05/30/24 Prior Authorization Requests May Be Needed Due to Pharmacy Claims Processing Error
- 05/29/24 Updated PEAQSM Methodology Is Now Available
- 05/23/24 Earn Continuing Education Credit: Webinar on Trauma-Informed Care
- 05/21/24 Access MCG Care Guidelines Clinical Criteria via Availity® Essentials
- 05/16/24 Closing Gaps in Care for Group Medicare Advantage (PPO) members
- 05/14/24 ClaimsXten™ Quarterly Update Effective Aug. 19, 2024
- 05/09/24 Pharmacy Program Updates: Prior Authorization Changes Effective Aug. 1, 2024
- 05/08/24 Pharmacy Program Quarterly Update: Changes Effective July 1, 2024 – Part 1
- 05/07/24 Reminder: Transition of Care for Blue Cross Community Health PlansSM
- 05/01/24 Electronic Claim Reconsideration Requests and Tips for Correct Use of Claim Review Forms
- 04/30/24 Save the Date for Our Second Quarter Professional Provider Forum
- 04/24/24 Supporting Maternal Quality Care
- 04/23/24 Requests for Behavioral Health Documentation for Medicaid Members
- 04/22/24 BCCHPSM and MMAI Providers: Join Our Community Stakeholder Committee
- 04/19/24 Coding Webinars: Arrhythmias and Rheumatoid Arthritis
- 04/18/24 Important Updates to Manage My Organization in Availity® Essentials
- 04/16/24 Chronic Kidney Disease: Help Your Patients Understand Risk Factors and Preventive Measures
- 04/11/24 Use Our New Form for Anti-VEGF Intravitreal Injection Therapy Verification
- 04/10/24 Pharmacy Program Updates: Prior Authorization Changes Effective June 15, 2024
- 04/10/24 Filing Claims for Applied Behavior Analysis Services – Use the Correct Place of Service Code
- 04/03/24 See CMO Perspective for ‘Heart Disease: What We Can Do To Empower Patients and Save Lives’
- 04/02/24 Pharmacy Program Quarterly Update: Changes Effective April 1, 2024 – Part 2
- 04/01/24 Caring for Substance Use Disorders
- 03/29/24 Late and Added Charges Must Be Submitted as a Corrected Claim
- 03/28/24 Prior Authorization Requirement Changes for Some Commercial Members
- 03/28/24 Prior Authorization Changes for Government Programs
- 03/27/24 Webinar on Coding for Annual Wellness Visits
- 03/25/24 Pharmacy Program Updates: Prior Authorization Changes Effective June 1, 2024
- 03/15/24 Earn Continuing Education Credit: Webinar on Substance Use Disorder
- 03/14/24 ClaimsXten™ Quarterly Update Effective June 17, 2024
- 03/11/24 Medicaid Update: Pharmacy Appeals Transition, Effective April 1, 2024
- 03/07/24 Billing Guidelines for Laboratory Claims
- 03/01/24 Change Healthcare Cybersecurity Incident Impact and Options
- 02/28/24 Reminder: Update Your Records with New Mailing Address for Paper Claims
- 02/27/24 30-Day Facility Readmission Reviews for Medicare Advantage Members
- 02/26/24 Avoiding the Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
- 02/23/24 Earn Continuing Education Credit: Webinar on Social Determinants of Mental Health Care
- 02/20/24 Pharmacy Program Updates: Prior Authorization Changes Effective May 1, 2024
- 02/14/24 Save the Date for Our First Quarter Professional Provider Forum
- 02/13/24 See CMO Perspective for Ideas To Help Patients Set and Keep Healthy Goals Throughout the Year
- 02/13/24 Medicaid Health Benefits for Immigrant Adults and Seniors Program
- 02/12/24 Copay Changes to Immigrant Adults and Seniors Program
- 02/07/24 Pharmacy Program Quarterly Update Changes Effective April 1, 2024 – Part 1
- 02/01/24 Medicare Advantage HEDIS® Records Collection through June 2024
- 01/31/24 Changes Coming to Claim Inquiry Resolution – Itemized Bill Review Only
- 01/26/24 Supporting Healthy Hearts
- 01/25/24 Managing Our Members’ Antidepressant Medication
- 01/24/24 Pharmacy Program Updates: Prior Authorization Changes Effective April 1, 2024
- 01/24/24 Earn Continuing Education Credit at Webinar on Pediatric Behavioral Health
- 01/23/24 Coding Webinars: Major Depressive Disorder and Annual Wellness Visits
- 01/23/24 Pharmacy Program Quarterly Update: Changes Effective Jan. 1, 2024 – Part 2
- 01/22/24 Utilization Management: Avoid Delays and Denials
- 01/19/24 MMAI and BCCHPSM Providers: Join Our Community Stakeholder Committee
- 01/11/24 ClaimsXtenTM Quarterly Update Reminder Effective April 15, 2024
- 01/09/24 Pharmacy Program Updates: Prior Authorization Changes Effective April 1, 2024
- 01/05/24 Appropriate Use of Opioids Program Retired January 2024
