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Policy Clarification for Practitioner Medication Dispensing

Audience: Medicaid Enrolled Prescribing Practitioners

Under New York State Education Law, Article 137 §6807, practitioners who are authorized to prescribe can dispense medications directly to their patients. Additional registration or ownership of a pharmacy is not required. This dispensing must be done in accordance with...

Medicare Advantage Prior Authorization for Select Oncology Medications

Audience: Prescribing Providers

In an effort to reduce costs while maintaining high safety, efficacy, and quality standards, we are implementing new prior authorization (PA) requirements on select medical benefit oncology medications for members enrolled in Medicare Advantage plans. For members...

Streamlined Preauthorization for Medical Specialty Drugs for Commercial Fully Insured Members Effective January 1, 2023

Audience: Prescribing Providers

Based on feedback received from prescribing providers related to notification review/preauthorization requirements for medical specialty drugs, Excellus BlueCross BlueShield will update its requirements for commercial fully insured members effective January 1,...

Updated Participating Provider Manual Now Available

Audience: Participating Physicians, Health Care Practitioners and Facilities

The Excellus BlueCross BlueShield Participating Provider Manual has been updated and is now available on our website, Provider.ExcellusBCBS.com/policies/manuals. You will need to log in to the secure portion of the website to view the manual. Once logged in, you now have...

Medicare Advantage Changes Effective January 1, 2023

Audience: All providers

Medicare Advantage members will receive their Annual Notice of Changes soon with details about the following benefit and administrative changes effective January 1, 2023. The Annual Enrollment Period extends from October 15 to December 7, 2022. Medicare beneficiaries...

Reminder: Pharmacy Billing Guidance for Non-Enrolled Unlicensed Prescribers

Audience: Pharmacies

The New York State (NYS) Medicaid program requires enrollment of all licensed providers who serve Medicaid members, including prescribing practitioners identified on pharmacy claims, per the Centers for Medicare & Medicaid Services (CMS) and federal...

NDC Billing Requirement Update Effective December 1, 2022

Audience: Participating Prescribing Providers

To ensure that your claims are submitted accurately, and to allow for timely processing and correct reimbursement, please review the claim billing requirements effective December 1, 2022, for the following drugs: HCPCS Code Description ...

Register to Receive our Newsletter and Other Communications Electronically

Audience: Participating Physicians, Health Care Practitioners and Facilities

**If you already receive email notification each month when the latest issue of our Connection newsletter is available online, you can disregard this notice.**  We encourage you to take a moment to visit our website and register to receive electronic communications...

Clinical Editing Policies Effective December 1, 2022

Audience: All Providers and Facilities

We would like you to be aware of new clinical edits effective for dates of service on or after December 1, 2022. These edits do not impact the retrospective review of claims that currently occur, and apply to physicians, practitioners, laboratories, outpatient facilities...

Resumption of Utilization Review Requirements Suspended Under NYS Executive Order #4

Audience: Participating Hospitals

Note: If your NYS-approved certification to suspend preauthorization requirements has already ended at your request, please disregard this message. The New York State Department of Health (NYS DOH) has announced that it will not continue the suspension of utilization...

Training Opportunity with the March of Dimes

Audience: Participating Providers

Excellus BlueCross BlueShield has partnered with the March of Dimes to offer you the following virtual training: Awareness to Action: Dismantling Bias in Maternal and Infant Health Care Please join us for one of the following sessions: September 24, 2022,  9 a.m....

Holiday Office Closures and Pay Cycle Schedule Changes for Remainder of 2022

Audience: Participating Physicians, Practitioners, Facilities and Hospitals

To help you plan ahead, we are providing you with advance notice of Health Plan office closure information for the following holidays. Please refer to this convenient chart as a guide to our upcoming closures and pay cycle schedule changes for all lines of business. Your...

Medical Policy Update: Minimally Invasive Treatments Prostatic Hyperplasia

Audience: Participating Urologists

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...

Training Opportunity: eviCore Cardiology Preauthorization Tool

Audience: Participating Cardiologists

In preparation for the October 1 implementation of preauthorization requirements for outpatient transthoracic and transesophageal echocardiography services, we are pleased to share information about upcoming virtual training sessions available to assist you. Excellus...

Faxing Medical Records – New Page Limit

Audience: All Providers

Our goal is to help reduce your administrative burden and costs as you conduct business with the Health Plan. As part of this effort, we would like to suggest solutions for reducing the amount of paper your office generates when transferring important medical record...

Showing 1– 15 of 81 Results

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