July 2015

(Electronic distribution July 10, 2015)

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ICD-10: Quick Facts and Resource Reminders
The transition to ICD-10 on Oct. 1 is a reality. To help you make the transition, we provide numerous industry training, educational resources and frequently asked questions that any size practice may use to prepare.

It's Not Too Late to Enroll for ICD-10 Testing with BCBSTX
Confirming ICD-10 readiness with your software vendor, billing service or clearinghouse is just the first step. End-to end or “round-trip” testing with payers can help ensure your claims make a successful journey from start to finish. Test with BCBSTX to ensure you are ready.

Tips to Help Your Patients Improve Medication Adherence
Nearly three out of four Americans do not take their medications as directed, according to national organization. BCBSTX is here to help prescribing providers increase awareness of adhering to medication protocols and promote patient safety.

Pharmacy Program Update: Formulary Changes Effective July 1
Based on the availability of new prescription medications and the Prime’s National Pharmacy and Therapeutics Committee’s review of changes in the pharmaceuticals market, some revisions were made to the BCBSTX standard drug list effective July 1, 2015.

Modifier 25 Reminders
The Current Procedural Terminology (CPT^®) codebook defines Modifier 25 as a “significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service.” We provide several tips to use when submitting a Modifier 25 claim review.

Reminder: Claim Status Option to Exit Automated Phone System, Effective July 13
Beginning on July 13, claim status will no longer be available through our interactive voice response (IVR) phone system, but it will continue to prompt callers for the type of request (eligibility and benefits, claims, preauthorization or other services). Get the details.

Notices and Announcements
In this issue of the newsletter, we remind you of the ICD-10 Oct. 1 transition deadline and announce webinars on how to use ICD-10 for online benefit preauthorization requests. 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 the details.

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

Update your contact information
Accurate provider directories are an important part of providing BCBSTX members with the information they need to manage their health.

To update your contact information, please submit your correspondence via fax to 972-231-9664 or mail 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 change.

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 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.