April 2015

(Electronic distribution April 1, 2015)

Where You Go Matters: Member education campaign focuses on level of care options
Our claims activity has shown members are selecting the emergency room as their first choice for care even when other settings may be more clinically appropriate. To help members make better-informed decisions, BCBSTX is launching a member educational initiative, “Where You Go Matters.”

CMS reports preliminary ICD-10 testing results; BCBSTX begins testing in April
The Centers for Medicare & Medicaid Services (CMS) has announced successful completion of the first of three ICD-10 end-to-end testing weeks. Approximately 660 health care providers, billing services and other stakeholders participated. BCBSTX will begin ICD-10 testing this month.

Medical policy update reminder: Diagnosis and medical management of sleep related breathing disorders
An important change to the BCBSTX Medical Policy for Diagnosis and Medical Management of Sleep Related Breathing Disorders (MED205.001) will take effect for dates of service on or after May 1, 2015. This policy has been revised to establish new criteria and guidance for testing in the diagnosis of Obstructive Sleep Apnea.

Notices and Announcements
In this issue, we remind you about the behavioral health Coordination of Care form that is now available online. Get the details.

In Every Issue
BCBSTX is required to provide certain notices in all published correspondence with physicians and professional providers. For the latest updates, visit the News and Updates area of the BCBSTX website at bcbstx.com/provider. Get the details.

Contact Us
Click here for a quick directory of contacts at BCBSTX.

Update Your Contact Information
To update your contact information, please submit your correspondence via fax to 972-231-9664 or mai to P.O. Box 650267, Dallas, Texas, 75265-0267. You should submit all changes at least 30 days in advance of the effective date of the change.

If your specialty, practice information/status or board certification is not correct on BCBSTX Provider Finder^®, or if you would like to have a subspecialty added, please contact your Network Management office.

Blue Review is published for Blue Choice PPO^SM, HMO Blue Texas^SM, Blue Cross Medicare Advantage (PPO)^SM, Blue Advantage HMO^SM and ParPlan contracting physicians and other health care providers. Ideas for articles and letters to the editor are welcome; email BlueReviewEditor@bcbstx.com.

The information provided in Blue Review does not constitute a summary of benefits, and all benefit information should be confirmed or determined by calling the customer service telephone number listed on the back of the member ID card.

BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by independent, third-party vendors mentioned in this newsletter. The vendors are solely responsible for the products or services they offer. If you have questions regarding any of the products or services mentioned in this periodical, please contact the vendor directly.

Blue Cross^®, Blue Shield^® and the Cross and Shield symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.