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Latest News

Medicare MS-DRG Payment Add-On for COVID-19 Hospitalizations

Audience: Participating Hospitals

Excellus BlueCross BlueShield has updated the weighting factor of the assigned Medicare severity  diagnosis-related group (MS-DRG) by 20 percent for COVID-19-related hospitalization claims processed  on or after June 12, 2020, for our Medicare Advantage members....

Hyaluronic Acid Preferred Therapy Update

Audience: Specialty Providers

We want to make you aware of an upcoming change regarding treatment with hyaluronic acid therapy. Effective October 1, 2020, Euflexxa, Synvisc, and Synvisc-One will be our preferred hyaluronic acid therapy products for the treatment of pain in osteoarthritis (OA) of the...

Eyewear Benefit Clarification for MMC and HARP Members

Audience: Participating Vision Care Providers

We would like to provide clarification of the eyewear benefit for Medicaid Managed Care (MMC) and Health and Recovery Plan (HARP) members related to standard vs. non-standard/deluxe frames and lenses. This applies to our members with HMOBlue Option, Blue Choice Option,...

Hemlibra Requires Prior Authorization Effective October 1

Audience: Providers of Impacted Members

We would like you to be aware of an upcoming change related to the management of Hemlibra®. Starting October 1, 2020, Hemlibra will be covered under the medical benefit and will require prior authorization for all Commercial, Medicare and Safety Net (Medicaid, HARP,...

Metformin ER Recall

Audience: Providers of impacted members

Amneal Pharmaceuticals LLC and Apotex Corp. are voluntarily recalling all lots of Metformin Hydrochloride Extended Release Tablets, USP, 500 mg and 750 mg, within expiry to the Consumer Level. The recall is due to the potential N-Nitrosodimethylamine (NDMA) levels greater...

AP-34 Optometry Scope of Practice Administrative Policy Effective October 1, 2020

Audience: Optometrists

Excellus BlueCross BlueShield is implementing the following administrative policy October 1, 2020, to define the coverage and billing guidelines for Optometry Scope of Practice. This policy is in line with Current Procedural Terminology (CPT), and Healthcare Common...

COVID-19 Reimbursement of Preventive Health Visits via Telehealth Extended to September 7

Audience: Participating Physicians

In our communication dated May 13, 2020, we shared the Health Plan’s commitment to ensure continuity of care for our members during the COVID-19 state of emergency, and our efforts to eliminate barriers to providing care during this unprecedented time.  We...

Musculoskeletal Preauthorization Procedure for Essential Plan Members Effective August 1

Audience: Physicians, Hospitals

We advise you that effective August 1, 2020, preauthorization requests for musculoskeletal procedures pertaining to Essential Plan members must be submitted directly to the Health Plan. Musculoskeletal-related requests for Commercial and Medicare Advantage business should...

Requesting Additional Visits in CareAdvance Provider® Tool

Audience: Physical, Occupational and Speech Therapists

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...

COVID-19 Diagnostic & Antibody Testing Administrative Policy & Information for all Lines of Business

Audience: Physicians, Hospitals, Facilities and Laboratories

In our communication to you dated May 21, 2020, we shared Health Plan coverage guidelines and member cost-share information related to COVID-19 diagnostic/viral and antibody testing for our commercial members. The information and guidance we shared in our May 21, 2020...

Electronic Submission Tools

Audience: All providers

To make it easier and more efficient to conduct business with our Health Plan, we are enabling more real-time automation to reduce your administrative burden. As part of our continuing effort to improve our service, we are offering the following electronic submission...

COVID-19 Telemedicine Services for Federal Employee Program Members

Audience: Physicians and Professional Health Care Providers

We would like to clarify cost-share information related to COVID-19 telemedicine services provided to members with coverage through the Federal Employee Program (FEP) during the COVID-19 state of emergency. FEP will waive the member cost-share for telemedicine services...

New Membership Effective July 1, 2020 – Diocese of Syracuse

Audience: Participating Dental providers

Excellus BlueCross BlueShield is pleased to announce the addition of Diocese of Syracuse as a new employer group effective July 1, 2020. Please see below for important information for your office or facility.  Product Information and Member Cards Diocese of...

New Membership Effective July 1, 2020 – Elmira City School District

Audience: Participating Professional and Ancillary providers

We are pleased to welcome Elmira City School District as a new employer group with Excellus BlueCross BlueShield starting July 1, 2020. Please review the important information below and share it with anyone in your practice or facility who needs to know. Product...

COVID-19 In-Network Outpatient Behavioral Health Services for Essential Workers

Audience: Behavioral Health Providers and Facilities

On May 2, 2020, the New York State Department of Financial Services issued an emergency regulation and circular letter that waives member cost-share for outpatient mental health services provided to essential workers during the COVID-19 state of emergency. Under this new...

Showing 61– 75 of 139 Results