Provider Information on COVID-19 Coverage | view in Web Browser
A newsletter for physician, professional, facility, ancillary and Medicaid providers |
April 2020
Medicaid
Monthly News for Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid (STAR), STAR Kids and CHIP Providers
Read this month’s Medicaid news to learn about:
Notices & Announcements
Provider Information on COVID-19 Coverage
We’re all in this together. We are covering testing to diagnose the 2019 novel coronavirus (COVID-19) for most members with no prior authorization needed, and no member copays or deductibles.
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Telemedicine and Telehealth Coverage Expansion in Response to COVID-19
The bottom line: We’re responding to COVID-19 by expanding our coverage for medical and behavioral health telemedicine and telehealth visits. This allows members to access care while reducing their risk of exposure.
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iExchange® Deactivates April 15, 2020 — Use Availity Authorization & Referrals
iExchange is being deactivated on April 15, 2020. Be sure to transition to Availity Authorizations & Referrals for online prior authorization and referral submissions. Check News and Updates on our provider website for additional information.
Behavioral Health
2019 Behavioral Health Quality Improvement Program Evaluation Executive Summary
Looking ahead: Based on the review of our 2019 program goals, an increased understanding of barriers to improvement and lessons learned during 2019, we have narrowed our focus areas to improve our behavioral health program.
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Claims & Eligibility
Clarification: New BCBSTX 837 Commercial Claim Validation Edits Effective April 1, 2020
What’s changed: Beginning April 1, we implemented new electronic claim submission validation edits for commercial professional and institutional claims (837P and 837I transactions). Learn what this means and what you should do.
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Clinical Payment and Coding Policy Updates
The Clinical Payment and Coding policies published on our website describe payment rules and methodologies for CPT®, HCPCS and ICD-10 coding for claims submitted as covered services. This information is offered as a resource for our payment policies; it is not intended to address all reimbursement-related issues. We regularly add and modify clinical payment and coding policy positions as part of our ongoing policy review process. The following policy was recently added:
- Medical Record Documentation Guideline – Effective 3/10/2020
- Telemedicine and Telehealth Services – Effective 5/10/2020
- Inpatient Readmissions – Effective 6/20/2020
Reminders:
Pharmacy
Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2020 — Part 2
Review drug list changes, updates and revisions that go into effect April 1.
Reminder:
Health & Wellness
New Annual Wellness Visit Resources for Medicare Providers
Making life easier: To help meet Medicare requirements, we’ve launched two new resources for you to document patient visits.
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Network Participation
Using the Online Tool to Search for Doctors and Hospitals
Easy way to stay current: Use our online Provider Finder® tool to ensure your information is correct/up-to-date so members have an easy time connecting with you.
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Reminder:
Prior Authorization Information
Reminders:
Education & Reference
Complimentary Webinar Trainings Available
Do you have new staff or need a refresher about electronic options? If yes, we have added complimentary educational webinar sessions on the BCBSTX provider website for provider billers, utilization areas and administrative departments. Topics include Availity 101, Availity Authorizations & Referrals and Remittance Viewer. Please visit the Provider Training page on our provider website throughout the year to view available training topics and sign up for sessions.
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an Independent Licensee of the Blue Cross and Blue Shield Association
1001 E. Lookout Drive, Richardson, TX 75082
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