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Coding resources Coding types and sources Coding Set up and manage your electronic payments from Blue Cross. 107. March 2023 Anthem Provider News - Kentucky, February 2023 Anthem Provider News - Kentucky, New ID cards for Anthem Blue Cross and Blue Shield members - Kentucky, Telephonic-only care allowance extended through April 11, 2023 - Kentucky, January 2023 Anthem Provider News - Kentucky, November 2020 Anthem Provider News - Kentucky. There may be times when these policies are superseded by state, federal or CMS requirements. To view this file, you may need to install a PDF reader program. External link You are leaving this website/app (site). If you have any questions about specific aspects of this information or need clarifications, please email. Search for meal delivery, transportation, job training and other services near you. External link You are leaving this website/app (site). Considerations for 2022 rate increases for Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc., individual and small group products include: Expected medical trend in both utilization and cost of services Expected changes in the average morbidity (Individual products only) The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. You can count on our affordable plans and extensive networks no matter what part of Louisiana you call home. The information above is not intended to be an exhaustive listing of all changes. We look forward to working with you to provide quality services to our members. | In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, Anesthesia Clinical Payment and Coding Information, Coordinated Home Care/Private Duty Nursing, Drug Testing Clinical Payment and Coding Policy, Evaluation and Management (E/M) Services Coding Facility Services, Evaluation and Management (E/M) Coding Professional Provider Services, Increased Procedural Services (Modifier 22), Intraoperative Neurophysiology Monitoring Coding and Reimbursement Guideline, Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy, Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU), Observation Services Tool for Applying MCG Care Guidelines Clinical Payment and Coding Policy, Outpatient Facility and Hospital Claims: Revenue Codes Requiring CPT or HCPCS Codes, Paravertebral Facet Injection Procedure Coding & Billing Policy, Point-of-Care Ultrasound Examination Guideline, Psychological and Neuropsychological Testing, Therapeutic, Prophylactic and Diagnostic Injection and Infusion Coding, Unlisted/Not Otherwise Classified (NOC) Coding, Wasted/Discarded Drugs and Biologicals Guideline. Anthem is a registered trademark of Anthem Insurance Companies, Inc. If you want to see if the prescription drugs you're taking are covered by your plan, use the drug lists below. This new site may be offered by a vendor or an independent third party. Providers and facilities are required to use industry standard codes for claim submissions. Enrollment in either Blue Advantage plan depends on contract renewal. Type at least three letters and we will start finding suggestions for you. We work with doctors, hospitals and clinics around Louisiana to make sure you have a better healthcare experience. If you just found out that you need surgery, or if you will be admitted to a hospital or ambulatory surgical center for any reason, you will most likely receive some care during your stay from a hospital-based physician. In addition, some sites may require you to agree to their terms of use and privacy policy. Blue Cross and Blue Shield of Texas (BCBSTX) is implementing changes in the maximum allowable fee schedule for Blue Choice PPOSM, Blue EssentialsSM (including HealthSelectSM of Texas Network), Blue PremierSM, Blue Advantage HMOSM, MyBlue HealthSM and PAR Plan networks (collectively referred to as "Networks") effective March 1, 2020. For login/access issues call (800) 716-2299 option 5 or email PIMTeam@bcbsla.com. If you don't receive a notification from us, our dental fee schedule hasn't changed. Please fax the completed form to (716) 887-2056, along with your Certificate of Liability Insurance. The site may also contain non-Medicare related information. You also get extra benefits at no additional cost. Find previous articles about network, admin rep, Blue Advantage and other special topics. Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc. an independent licensee of the Blue Cross and Blue Shield Association. 100748 0521 R3 Page 1 COVID-19 Provider Billing Guidelines In response to the coronavirus disease (COVID-19), we've established billing code guidelines for our Commercial, Affordable Care Act (ACA), . | Now is the time to find the right Medicare plan that fits your changing healthcare needs. This information does not apply to members who have Medicaid or Medicare plans. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Refer to the Member's plan of benefits or Certificate of Coverage to determine whether coverage is provided or if there are any exclusions or benefit limitations applicable to any of these policies. The Local Plus plan is ideal for members who prefer the predictability of co-payments rather than using employer funding to offset out-of-pocket costs. Visit an inmate: To visit an inmate at Kalamazoo County Jail, you must schedule a visitation appointment. M. members covered. Your card opens the door to a large network of top doctors to care for you. Evaluation & Management services Espaol | Here's what you need to know about this change. Learn more about what's covered and what's available to you on your new health plan. Learn more. To access this area, please obtain the password from your Network Management Office. For your convenience, we have formatted the fee updates spreadsheets to include a sort filter on each column and an added column displaying the percentage of change in the total fee. Reimbursement Policies | Healthy Blue Louisiana Reimbursement Policies We want to assist physicians, facilities and other providers in accurate claims submissions and to outline the basis for reimbursement if the service is covered by a member's benefit plan. Log in to your online account to view and download a digital version of your Blue Cross member identification card. | To access the updates, log in to azblue.com/providers and go to Provider Resources > Guidelines > Claim Pricing. Select one of the Fee Updates links: ASC, Outpatient, Professional, Unclassified Drug, or Per Diem Base Rates. Portugus | One option is Adobe Reader which has a built-in reader. Blue Cross and Blue Shield of Louisiana, an independent licensee of the Blue Cross Blue Shield Association, offers Blue Advantage (PPO). Milliman Care Guidelines (MCG) and the CMS Provider Reimbursement Manual. Local Provider Directory Laboratory fee schedules are available online. If you have any questions, please contact your Network Management Office. Alaska Fee Schedule | Provider | Premera Blue Cross Blue Shield of Alaska Alaska Fee Schedule March 4, 2021 We're updating the Premera Blue Cross Blue Shield of Alaska plan fee schedule for professional services effective for dates of service beginning May 15, 2021. The conversion factor for certain codes may vary by place of service. For more information on the above change(s), use our Fee Schedule Request Form and specifically request the updates on the codes listed in the Blue Review. Complete the form and select Submit to receive the appropriate professional fee schedule (s). As in the past, BCBSRI uses the Rhode Island Medicare Fee Schedule (RIMFS) and its resource-based relative value scale (RBRVS) pricing methodology, as the basis for development of our fee . Effective January 1, 2021, Anthem Blue Cross and Blue Shield Medicaid (Anthem) will update the Reference Laboratory Fee Schedule for Anthem. Select a Region: Please Select One DVEST1 DV9ST1 DV8ST1 DV5ST1 DV4ST1 DV1ST1 DVPST1 DVOST1 DVMST1 DVJST1 DVHST1 DVGST1 DVFST1 DVEST1 DVDST1 DVCST1 LOEST1 Read documents about clearninghouse services, claims, remittance and other services. Our new Blue Advantage Provider page is designed to give you access to the most current Blue Advantage resources. Our dental plans cover preventive care and more. Blue Advantage from Blue Cross and Blue Shield of Louisiana HMO is an HMO plan with a Medicare contract. A Fee-For-Service Plan (FEP Blue Standard and FEP Blue Basic Options) with a Preferred Provider Organization . Independent licensees of the Blue Cross and Blue Shield Association. Y0132_23-205_MKLA - Last Updated 01/05/2023. Stay connected with what is going on at Blue Cross with our provider newsletters. Find out more about this imaging assessment shopper program. As part of our commitment to help inform our independently contracted providers of certain developments, Blue Cross and Blue Shield of Illinois (BCBSIL) has designated a specific section in the Blue Review to notify you of any significant changes to the physician fee schedules. Important Information from Blue Cross and Blue Shield of Louisiana: Hurricanes COVID-19 And we do research to make sure the drugs . Students are eligible to receive the reward for 1st, 2nd, or 3rd doses, everyone else is 1st dose only. Blue Cross members of both individual and employer health plans will be able to get a U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccine for $0 out of pocket. We offer three Traditional plans and three Certified plans to meet your needs. To view the NDC Reimbursement Schedule, registerorlog into Blue Access for Providers. National Drug Code (NDC) Reimbursement Schedule Date: Effective July 1, 2019, we are updating our standard fee schedule and rates. | Espaol | Blue Cross and Blue Shield of Louisiana is licensed to sell products only in the state of Louisiana. Copyright 2022 Blue Cross and Blue Shield of Louisiana. | All the drugs on our drug lists have been approved by the U.S. Food and Drug Administration. Please note that deleted codes will not be accepted for payment for dates of service on or after Jan. 1, 2023. Visit Blue365. Open Enrollment may be over, but you could still be eligible for coverage with a qualifying life event. We are excited to announce the release of Provider Contract and Fee Schedule Notifications! In Maine: Anthem Health Plans of Maine, Inc. The site may also contain non-Medicare related information. You are leaving the Blue Cross and Blue Shield of Louisiana (BCBSLA) website. Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc., an independent licensee of the Blue Cross and Blue Shield Association. It's also called a formulary. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. * Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid. Effective January 1, 2021, Anthem Blue Cross and Blue Shield Medicaid (Anthem) will update the Reference Laboratory Fee Schedule for Anthem. Look for the "Fee Schedule" link under Payment & Refund in the main menu. With gym packages starting at $19 a month, you'll have access to 11,000 participating fitness locations around the state and nation. Get discounts on gym memberships, fitness gear, healthy eating, prescriptions and more. | This new site may be offered by a vendor or an independent third party. Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Once you have logged in, the fee schedule links are located under the Resource tab. Blue Cross wants to help your patients live healthy lives. We want to assist physicians, facilities and other providers in accurate claims submissions and to outline the basis for reimbursement if the service is covered by a members benefit plan.