January 2016

(Electronic distribution January 6, 2016)

View a printable PDF of this newsletter.

Blue Advantage HMO^SM and Blue Advantage Plus^SM HMO Provider Webinar Sessions for 2016
We will be hosting four provider webinar training sessions in January and February to review products offered on the Health Insurance Marketplace in 2016. Join us!

Implementation Reminder: Three New Facility Rules for ClaimsXten™
Three new facility rules that were originally scheduled to be added to our claims processing system in October will now be postponed to on or after Feb. 22. Get the details.

Pharmacy Program Benefit Changes – Effective Jan. 1, 2016
BCBSTX will be implementing pharmacy benefit changes as of Jan. 1, 2016, for some members with prescription drug benefits administered through Prime Therapeutics. Letters will be sent alerting members who may be taking or prescribed a medication that may be affected by the 2016 pharmacy benefit changes.

Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Jan. 1, 2016
Please take a moment to review the updates that will be made to the BCBSTX standard and generics-plus drug lists effective Jan. 1, 2016.

Notices and Announcements
In this issue of the newsletter, we provide information about the requirement to collect medical record data, the federal employee program, Medicare Part D formulary changes and a new rule that requires providers who prescribe Part D drugs to enroll in Medicare. 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 provider website. Get started now on reviewing this month's articles.

Contact Us
View our quick directory of contacts at BCBSTX.

Update Your Contact Information
Accurate provider directories are an important part of providing BCBSTX members/subscribers with the information they need to manage their health.

To update your contact information,you should submit all changes at least 30 days in advance of the effective date of change. Please submit your correspondence via:

• fax: 972-231-9664
• mail: P.O. Box 650267, Dallas, Texas, 75265-0267

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

In addition, BCBSTX periodically identifies providers who have not submitted claims for a period of one year. We make an effort to contact each provider to confirm their information. If the provider does not respond, we will initiate a network termination. Similarly, BCBSTX will inactivate any tax identification numbers (TINs) under which there have been no claims submitted for a period of one year.

Blue Review is published for Blue Choice PPO^SM, HMO Blue Texas^SM, Blue Cross Medicare Advantage (PPO)^SM, Blue Advantage HMO^SM, Blue Premier 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.