Category: BCBS (Various States)

Find medical billing and medical coding guidance for BCBS Empire Plan (Multiple States).

Posted in BCBS (Various States), Training

BCBS of Minnesota: Medical and Pharmacy benefit updated 09/05/2022

Posted on by KR2Medical Billing

The following prior authorization changes apply to BCBS of Minnesota Commercial and/or Medical Advantage Plan types.

The changes will take affect on 09/05/2022 and for all of the DOS thereafter.

If you are physician that provides above mentioned services to the BCBS of MN members of commercial and/or medicare advantage plans and you have questions,
please contact provider services at (651) 662-5200 or 1-800-262-0820.

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Posted in BCBS (Various States), Training, Updates

Empire BCBS Ohio: new AIM Specialty Health phone numbers

Posted on by KR2Medical Billing

If you are a physician that is accepts Empire BCBS Ohio members and requests services through AIM Specialty Health then this blog post is for you!

The following AIM Specialty Health phone numbers are effective 04/01/2022

StateAIM phone number
effective April 1, 2022
Indiana(833) 775-1952
Kentucky(833) 419-1357
Missouri(833) 305-1807
Ohio(833) 404-1678
Wisconsin(833) 342-1253

The old AIM Specialty Health Numbers will NO LONGER be active on August 15, 2022 and thereafter.

Physicians are encouraged to utilize self service via AIM is to use the ProviderPortalSM .

There physicians can:

  • Check order status and view order history
  • Print/save PDF of order summary
  • Use multiple staff members to enter/view the practice’s orders
  • Increase payment certainty
  • Reference desk training and tutorials, including clinical criteria and CPT lists

To register your practice in ProviderPortal. If you are not already registered, go to providerportal.com to register.

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Posted in BCBS (Various States), NY Providers, Training, Updates

HEDIS Measure: Update Colorectal Cancer Screening for 2022

Posted on by KR2Medical Billing

Are you a primary care physician and is reporting HEDIS measures? Then this following blog post is for you.

In this blog post we will discuss the changes/updates that NCQA just released for HEDIS Colorectal Cancer Screening Measure.

Measure Description: Measures the percentage of members 45 to 75 years of age who had appropriate screening for rectal cancer. The Medicaid product was added to the administrative data collection method for this measure and the age range was changed to 45 to 75 years of age.

In order to meet this measure your patients need to fall in ANY of the following criteria:

  • Fecal occult blood test during the measurement year
  • Flexible sigmoidoscopy during the measurement year or the four years prior to the measurement year
  • Colonoscopy during the measurement year or the nine years prior to the measurement year
  • CT colonography during the measurement year or the four years prior to the measurement year
  • Stool DNA (sDNA) with FIT test during the measurement year or the two years prior to the measurement year

If you would like to report this measure via Electronic Clinical Data Reporting system you will need to select: Colorectal Cancer Screening (COL-E).

Reminder: please make sure to document all of needed information in the patient medical records.

#HEDIS #Cancer #primarycare #physicians #NCQA

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