Tagged with BCBS Blue Cross Blue Shield

Anthem – Enhanced Automated Claim Edits

Anthem is updating its editing systems to automate edits supported by correct coding guidelines, as documented in industry sources such as CPT®, HCPCS Level II, and ICD-10. Anthem states the enhanced editing automation will promote faster claim processing and reduce follow-up audits and/or record requests for claims not consistent with correct coding guidelines.

BCBS Vermont New, Revised and Deleted Codes Released

Following Blue Cross and Blue Shield of Vermont’s (BCBSVT) review of the CPT® and HCPCS additions, deletions and revisions for October 1, the insurer has made several changes involving prior approval, investigational services, and unit designation.

New Hampshire Anthem BSBS New Musculoskeletal Program

Effective March 1, 2018, AIM Specialty Health (AIM) will perform medical necessity review of certain elective surgeries of the spine and joints, as well as interventional pain treatment for fully insured Anthem BSBS NH members.

IL BCBSIL NDC Billing Update for Medicare Advantage Claims

Effective December 15, Blue Cross and Blue Shield of Illinois (BCBSIL) will implement edits to validate National Drug Code (NDC)s that are submitted on electronic and paper, professional and institutional Blue Cross Medicare Advantage (PPO) and Blue Cross Medicare Advantage (HMO) claims.

FL – 44.7% Proposed PPACA Rate Increase for 2018

Florida state officials have announced submission of the proposed rates for 2018 ACA plans. According to the announcement, premiums may increase by 44.7% next year for ACA compliant plans.

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