Posted in Insurance, Training, Updates

Empire BCBS of New York (commercial plans) Timely filling changes- 2020

Effective April 1st 2020 all claims (commercial plans) will be subject to 120 days timely filling requirement.

Things to consider:

1. This applies towards the dates of service rendered before 4/1/2020 AND for dates of service on or after 4/1/2020.

2. This applies to any claim submitted to Empire on 4/1/2020.

Example if patient was seen on 12/30/2019 and your office submits the claim on 4/1/2020 then claim will be denied for timely filling.

In network providers should receive an amendment to the provider agreement (effective date 4/1/2020)

Posted in Insurance, Updates

Empire BCBS (an Anthem Company)- New Provider Network for 2020

Episode 2.

Starting on 01/01/2020 Empire BlueCross BlueShield HealthPlus (Empire HealthPlus) will be introducing a new Network.

This network will replace the Pathway Enhanced Network. The name of this new network will be “Individual Network”. It will be used for commercial individual products that are available both on and off the healthcare exchanges.

Members that have benefits under this network will receive cards that say “Individual Network” on the bottom right side. (Example of the card is enclosed)

anthemcardexample

There Prefixes used will be: VJD or VFG

*Please take note that this is an HMO network. These members do not have out of network benefits.