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DDAVP Recall
Audience: Providers of impacted patientsFerring 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 providersWe 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 AgenciesPlease 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 AgenciesIn 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 LaboratoriesSyracuse 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 & FacilitiesExcellus 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 ProvidersEffective 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....
Extension of Outpatient Behavioral Health Services for Essential Workers During COVID-19 State of Emergency Audience: Behavioral Health Providers and Facilities
Audience: Behavioral Health Providers and FacilitiesOn July 30, 2020, the New York State Department of Financial Services issued an extension of its emergency regulation and circular letter, which was set to expire on July 31, 2020. The regulation waives member cost-share for outpatient mental health services provided to...
Register to Receive our Newsletter and Other Communications Electronically
Audience: Participating Physicians, Health Care Practitioners and Facilities**If you already receive an email notification each month when 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 from Excellus...
Cost-Share Error for RIT & Iron Workers Members Related to Non-COVID-19 Telehealth Services
Audience: Rochester Region ProvidersWe have become aware of a system issue that caused member cost-share information to be incorrectly loaded for our members with coverage through self-funded groups Rochester Institute of Technology (RIT) and Iron Workers District Council. This error caused these...
Billing Requirements for Administrative Policy AP-26 – COVID-19 Viral and Antibody Testing; Reimbursement Information
Audience: Physicians, Hospitals, Facilities and LaboratoriesExcellus 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...
CareAdvance Provider® Reminders
Audience: All providers, facilities, hospitalsThank you for the care that you deliver to our valued members each day. We would like to provide you with some helpful tips and reminders regarding CareAdvance Provider, our new online preauthorization tool for Safety Net, Commercial and Medicare Advantage lines of...
Medical Utilization Management Updates
Audience: All Providers, Facilities, HospitalsWe would like to share an overview with you regarding our standard medical Utilization Management (UM) Program updates coming soon. Breast reconstruction, including implant insertion, removal or reinsertion continues to require pre-authorization unless the member...
Reminder: Refund Request Notification Process
Audience: All providersWe are writing to remind you of our automated notification process for requesting a refund on any claim we paid or overpaid in error. When we process a retraction for claims we paid or overpaid in error, a refund request is immediately generated if we are unable to...
De-Implementing Temporary COVID-19 Hospital Contingencies
Audience: Participating HospitalsOn June 26, 2020, the New York State Department of Financial Services (NYS DFS) issued Supplement No. 2 to its Insurance Circular Letter No. 8. The supplement provides guidance that permits health insurers, including Excellus BlueCross BlueShield, to resume...