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Latest News

Change in Paper UB-04 Claim Form Submission - Present on Admission Indicator

Audience: Hospital providers

We would like to make you aware of a change in how UB-04 paper claim forms must be completed regarding the Present on Admission (POA) indicator for “exempt” diagnosis codes. Billing UB-04 Paper Claims: The POA indicator is the eighth digit of field locator (FL) 67 ̶...

Discontinuation of Utilization Management (UM) Fax Lines

Audience: Participating Physicians, Professional Health Care Practitioners & Facilities

We are working diligently to improve our service to you by implementing the most up-to-date technology available. As part of our effort, we will provide you with real-time, streamlined tools for submitting medical records related to preauthorization requests beginning on...

Breast Pump Administrative Policy Effective November 1, 2021

Audience: Durable Medical Equipment providers

Excellus BlueCross BlueShield is implementing the following administrative policy effective November 1, 2021 to define the coverage and billing guidelines for breast pumps billed by providers contracted to provide this service. You can access the individual policies by...

Facility Claim Recovery Audit Appeal Time Frame Returns to 30 Days

Audience: Participating Hospitals

With the expiration of the COVID-19 New York State of Emergency on June 24, 2021, Excellus BlueCross BlueShield will return to a 30-day appeal time frame for inpatient and outpatient claim recovery audits. To provide you with advance notice, the 30-day appeal time frame...

Chiropractic Care Medical Policy Update Effective October 20, 2021

Audience: Chiropractors

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...

Remittance Display Inaccuracy

Audience: Participating Dentists

Thank you to our dental providers who have contacted us regarding the incorrect patient responsibility and contractual adjustment information that is appearing on some dental claims listed on InstaMed® and Zelis Payments remittances. We would like you to know that we have...

Change in Coverage for Basaglar® for Medicaid Managed Care Members

Audience: Providers of impacted members

We would like you to be aware that we will no longer provide coverage for Basaglar® under our prescription drug formulary for members with HMOBlue Option, Blue Choice Option and Blue Option Plus coverage. This change is effective: September 1, 2021 We have notified...

Important Information for Our Health Care Provider Partners

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...

You are Invited! CareAdvance Provider® Authorization Tool WebEx

Audience: All Providers

Would you like training or just need a refresher for CareAdvance Provider, our web-based authorization tool? If so, we’re here to help! Join us for one of these upcoming webinars: Wednesday, August 11, 2021, 11 a.m.-noon Thursday, September 23, 2021, 1-2 p.m. Tuesday,...

Continued Waiver of Member Cost-Share for Telehealth Services and COVID-19 Treatment for Fully Insured Members

Audience: Professional Providers and Hospitals

We realize that many of our members may be struggling financially as a result of the COVID-19 pandemic. So, although some New York state emergency regulations and the New York State of Emergency have recently expired, Excellus BlueCross BlueShield has made the business...

Claims Submitted with Admission Source Code 8 (Court/Law Enforcement)

Audience: Participating Facilities

Excellus BlueCross BlueShield requires medical record review for claims received with Admission Source Code 8. This code applies if a patient was admitted to this facility either upon the direction of a court of law or upon the request of a law enforcement agency...

Expiration of Cost-Share Waiver for In-Network Outpatient Behavioral Health Services Provided In-Person to Essential Workers

Audience: Behavioral Health Providers and Facilities

The New York State Department of Financial Services has not extended the emergency regulation included in Insurance Circular Letter No. 10,  which waived member cost-share for in-network outpatient behavioral health services provided in-person to essential workers...

Juneteenth and Independence Day Pay Cycle Update

Audience: Participating Physicians, Practitioners, Facilities and Hospitals

Excellus BlueCross BlueShield will be closed on Friday, June 18, 2021, in observance of Juneteenth. There will be no pay cycle schedule changes due to Juneteenth. The Health Plan will also be closed on Monday, July 5, 2021, in observance of Independence Day. There will...

Telehealth Payment Parity Through March 31, 2022

Audience: All Participating Providers

As a health plan, we want to ensure the viability of providing appropriate medical services via  telehealth while also ensuring access to medical and behavioral health services. While we are beginning to see light at the end of the tunnel, we realize that our members...

Zelis Payment Delay

Audience: Participating providers

Due to an internal processing error, payments through Zelis® for the week ending May 21, 2021, are delayed as follows: Payment type Original date New date ACH electronic bank payments Thursday, May 27 ...

Showing 1– 15 of 125 Results
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