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Updates to Administrative Policy-15 Part III: Evaluation & Management and Vaccine Administration Effective December 17, 2020

Audience: All Physicians

Excellus BlueCross BlueShield is updating Administrative Policy-15 to include a new Part III effective December 17, 2020, to define billing and reimbursement guidelines. You can access the individual policies by clicking here. Note: You must login with your username and...

Physical, Occupational, and Speech Therapy Preauthorization Process Change

Audience: Primary Care providers, and Physical, Occupational and Speech Therapists

We would like you to be aware that effective January 1, 2021, Excellus BlueCross BlueShield will require preauthorization for all physical, occupational and speech services requested for our members who have Medicaid Managed Care and Health and Recovery Plan (HARP)...

Intensity Modulated Radiation Therapy for Prostate Cancer Update

Audience: Radiation Oncologists

Excellus BlueCross BlueShield works to ensure that the development of corporate medical policies occurs through an open, collaborative process. We encourage participating providers to become actively involved in medical policy development. Each month, draft policies are...

Medicare Advantage Changes Effective January 1, 2021

Audience: All Providers and Facilities

We would like you to be aware of the following benefit and administrative changes effective January 1, 2021 for our members who have Medicare Advantage coverage. Members will be notified of these changes in September. The Annual Enrollment Period (AEP) extends from...

Reminder: Updates to New Administrative Policy Effective October 1, 2020

Audience: Optometrists

On June 22, 2020, Excellus BlueCross BlueShield notified you of the implementation of Administrative Policy 34 – Optometry Scope of Practice (“AP-34”) effective October 1, 2020, to define the billing and reimbursement guidelines for certain surgical codes for eye and...

You are Invited! CareAdvance Provider® Authorization Tool WebEx

Audience: Providers

Are you familiar with CareAdvance Provider, our new web-based authorization tool that is available for authorizations?  If not, we’re here to help! Join us for one of the following informational WebEx presentations: Wednesday, September 16 at 11 a.m. Tuesday,...

Requesting Additional Visits in CareAdvance Provider® Tool

Audience: Physical, Occupational, and Speech Therapists and home care providers

Please remember when requesting additional visits for an existing authorization in CareAdvance Provider, you must complete the following steps: Locate and open the authorization entry. Be sure you have the correct provider in focus in the top right corner using the...

Prohibition on Billing our Members for Personal Protective Equipment (PPE)

Audience: Medical and Dental Service Providers

On August 5, 2020, the New York State Department of Financial Services (“DFS”) issued Circular Letter No. 14 (2020) regarding charges for personal protective equipment (“PPE”) by health care and dental care providers. The Circular Letter addresses complaints received from...

DDAVP Recall

Audience: Providers of impacted patients

Ferring Pharmaceuticals US is voluntarily recalling all lots on the market of DDAVP® Nasal Spray 10 mcg/0.1mL, Desmopressin Acetate Nasal Spray 10 mcg/0.1mL, and STIMATE® Nasal Spray 1.5 mg/mL listed in the table below to the consumer level. These products are...

Labor Day Pay Cycle Information

Audience: All providers

We are providing you with advance notice of a change to our pay cycle schedule due to the Labor Day holiday. These schedule changes will not affect your payment amount. Please note that BlueCard® (out-of-area) claims will be included in the pay cycle for the week of...

Extending Reimbursement, Cost-Share Waiver for COVID-19 & non-COVID-19 Telehealth Services

Audience: Providers, Hospitals and Certified Home Healthcare Agencies

Please review the important updates below related to our extension of the member cost-share waiver and continued provider reimbursement for COVID-19 and non-COVID-19 telehealth services. We will continue to monitor the federal public health emergency and the New...

Billing Clarification for HCPCS Codes G2023 and G2024- COVID-19 Specimen Collection

Audience: Skilled Nursing Facilities and Certified Home Health Care Agencies

In our communication to certified home health care agencies dated April 22, 2020, we included Healthcare Common Procedure Coding System (HCPCS) codes G2023 and G2024 on a list of visit codes that could be used during the COVID-19 state of emergency. These codes should...

COVID-19 Viral and Antibody Testing for Syracuse University Employees/Dependents

Audience: Physicians, Hospitals, Facilities and Laboratories

Syracuse University, a self-funded employer group, has advised Excellus BlueCross BlueShield that it will cover all COVID-19 viral and antibody testing for its employed members and eligible dependents, even when the testing is ordered or performed on an asymptomatic...

Updated Billing Requirements for Administrative Policy AP-26 COVID-19 Viral and Antibody Testing

Audience: Physicians, Nurse Practitioners, Labs & Facilities

Excellus BlueCross BlueShield implemented Administrative Policy AP-26 COVID-19 Viral and Antibody Testing (effective March 13, 2020) to define the coverage, reimbursement and billing guidelines for this testing when it is determined to be medically appropriate for the...

Updated Administrative Policy 32—Billing and Reimbursement Guidelines for Increased Procedural Services Effective July 21, 2020

Audience: All Providers

Effective July 21, 2020, Excellus BlueCross BlueShield is updating its administrative policy that defines billing and reimbursement guidelines for increased procedural services (i.e., modifier 22) billed on professional claims. You can access the individual policies....

Showing 1– 15 of 134 Results