Tagged with BCBS Blue Cross Blue Shield
Following a review of its current medical polices, Anthem BlueCross BlueShield (BCBS) has released an updated list of medical policies which will be converted to clinical guidelines, effective May 1.
Effective May 1, Anthem Blue Cross and Blue Shield in Virginia (BCBS VA) will implement new and revised coverage guidelines approved at the most recent quarterly Medical Policy and Technology Assessment Committee meeting.
The Texas Health and Human Services Commission (HHSC) has announced the six contract awards for the state’s Children’s Health Insurance Program (CHIP) Rural and Hidalgo Service Areas scheduled to begin on September 1.
Anthem Blue Cross and Blue Shield (BCBS) has published a notice informing health care professionals and policyholders that the insurer will no longer proceed with the reimbursement policy impacting physician use of payment Modifier 25.
In an effort to improve outcomes, increase quality, and lower healthcare costs within Medicaid populations, Delaware says it will move its managed Medicaid contracts to value-based agreements.
As of January 1st, Ohio Senate Bill 129 (House Bill 505) now requires insurers to implement faster turn-around times for reviews of prior-authorizations (PA) that are submitted electronically.
Effective with dates of service of February 1, 2018, and beyond, Highmark Blue Shield will require prior authorization for eleven procedure codes.
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.
Starting in 2018, more claim payments and remittance advice issued to Anthem providers will be made on a weekly basis.
Effective December 8, Anthem EDI began implementation of a new edit related to independent laboratory claims which reduces the processing time and manual intervention for lab claims.
For dates of service on or after December 1, 2017, Anthem Blue Cross and Blue Shield (Anthem BCBS) will begin reimbursement for Psychiatric Care Collaborative Management Healthcare Common Procedure Coding System (HCPCS Level II) codes.
Delaware’s Department of Health and Social Services (DHSS) has announced the names of the companies selected to operate its Medicaid Managed Care Program (MCO) in 2018
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.
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.
A medical policy from Blue Cross Blue Shield of Michigan sets the insurer apart as the first commercial payer to issue a positive coverage policy for a new lumbar spinal stenosis treatment.
The Office of the Health Insurance Commissioner approved health insurance premium rates in Rhode Island for 2018 that include exchange plan rate increases ranging from 5% to 12.1% for 2018.
The New York Department of Financial Services has released 2018 health insurance rates for the state’s individual and small group markets, including rates for the NY State of Health, New York’s official health plan marketplace – ranging from 4.4% for Excellus to 31.5%.
Anthem Blue Cross and Blue Shield released updated medical policies and clinical guidelines to be implemented on November 1, 2017 in certain states.
Blue Cross Blue Shield of Massachusetts (BCBSMA) has posted a new version of the Outpatient Surgical Day Care list intended to help providers determine the most appropriate setting for services receive.
Harvard Pilgrim, Maine Community Health Options, and Anthem Blue Cross Blue Shield are each requesting double-digit rate increases for 2018. The three insurers cite political uncertainty and a higher percentage of unhealthy policyholders as reasons for their requests.