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Psoriasis Laser Treatment Administrative Policy Effective September 1, 2021

Audience: Participating Physicians

Excellus BlueCross BlueShield is implementing the following administrative policy effective September 1, 2021 to define coverage and billing guidelines for laser treatment of psoriasis billed by providers contracted to provide this service. You can access the individual...

Vitamin D Testing Reminders

Audience: Primary Care Providers

Excellus BlueCross BlueShield’s medical policy 2.02.45, Screening for Vitamin D DeficiencyOpen a PDF, includes criteria used to determine coverage for vitamin D deficiency screening when it is considered medically appropriate for high-risk individuals. Screening for...

Preauthorization Updates Effective August 1, 2021 for All Lines of Business Requiring Preauthorization

Audience: All Providers

We would like to share updates regarding preauthorization under our Utilization Management (UM) Program. The UM Program gives Excellus BlueCross BlueShield and its health care provider partners the opportunity to monitor medical episodes of care to prevent unnecessary...

LBS Transition for May 1 for New Groups

Audience: Participating dental providers

Starting May 1, 2021, the employer group(s) listed below will be receiving new dental member cards. It’s important to check all Member Cards for benefits and eligibility at each visit. American Packaging Financial Institutions, Inc. LeChase Construction Product...

Upcoming Member Identification Card Changes

Audience: All Providers

We would like you to be aware that many of our members will soon begin receiving new Member Cards, due to enhanced requirements issued by the NYS Department of Financial Services (DFS).   The changes will apply to members who have fully insured, commercial coverage...

Clarification for COVID-19 Vaccine and Monoclonal Antibody Treatment Reimbursement for Commercial and Medicare Advantage Lines of Business

Audience: Physicians, Behavioral Health and Substance Use Facilities, Infusion Centers, Skilled Nursing Facilities, Home Health Care Providers

In previous communications related to the COVID-19 vaccine and monoclonal antibody treatment, we shared that we would mirror the Medicare rates established by the Centers for Medicare & Medicaid Services (CMS) for Medicare Advantage and commercial products/lines of...

Updates to our Contact Information for Electronic Claim Submission Inquiries

Audience: Physicians, Health Care Practitioners and Facilities

We would like to provide you with advance notice of a change to the contact information for inquiries related to the electronic claim clearinghouse or trading partner support. Effective July 1, 2021, please email EDI.Solutions@excellus.com for: All inquiries and...

Electronic Claim Adjustment Request Changes

Audience: All Providers

We would like to make you aware of upcoming changes to the electronic claim adjustment request process. Effective June 1, 2021, Excellus BlueCross BlueShield will no longer accept electronic adjustment requests for claims that have been finalized and additional...

Telehealth Requirement on Practitioner Demographic Changes Form

Audience: Participating Providers and Other Health Care Professionals

We would like to make you aware of an update regarding the telehealth question on the Practitioner Demographic Changes form. For demographic changes submitted with information in the address field(s), the “Is this address used for Telehealth services?” question is...

Medicare Advantage Dental Participation and Benefit Summary

Audience: Participating Dentists, Dental Office Managers and Staff

All dental providers participating with Excellus BlueCross BlueShield must also participate with Original Medicare (i.e., not opt-out) to receive payment for dental services provided to Medicare Advantage members. We pay dental providers directly based on the Excellus...

Updated Federal Guidance Related to COVID-19 Viral and Antibody Testing

Audience: Physicians, Hospitals, Facilities and Laboratories

The Health Plan implemented Administrative Policy AP-26, COVID-19 Viral and Antibody Testing and Supplies, at the start of the pandemic to define coverage, reimbursement, and billing guidelines for COVID-19 viral and antibody testing, consistent with the Families First...

Seneca Beverage - New Employer Group Effective April 1

Audience: Dental Providers

We are pleased to welcome Seneca Beverage as a new employer group with Excellus BlueCross BlueShield starting April 1, 2021. The group is transitioning from Lifetime Benefit Solutions to Excellus BCBS. It’s important to check all Members Cards for benefits and eligibility...

Continuous Glucose Monitoring System Medicare Prior Authorization Requirements

Audience: Participating Primary Care Providers and Endocrinologists

We are learning about some member confusion and frustration regarding prescriptions for Continuous Glucose Monitoring Systems (CGMS) being filled at retail pharmacies. While CGMS may be a covered benefit, prior authorization is required for Medicare Advantage members. ...

2021 Update to Inpatient SNF Care Benefit for FEP Standard Option Members

Audience: Skilled Nursing Facilities, Hospital Case Management and Discharge Planning Staff

We would like to make you aware that the skilled nursing facility (SNF) benefit available to Federal Employee Program (FEP) Standard Option members was updated effective January 1, 2021. This benefit provides up to 30 days of inpatient SNF care per benefit year for FEP...

Medicaid Managed Pharmacy Carve Out Notice for DME Providers

Audience: DME Providers

Change in Pharmacy Benefit for Medicaid Managed Care Members As you may know, effective May 1, 2021, pharmacy benefits for Medicaid Managed Care (MMC) and Health and Recovery Plan (HARP) members are covered under Medicaid Fee for Service (FFS) and not by Excellus...

Showing 1– 15 of 127 Results
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