June 2015

(Electronic distribution June 3, 2015)

View a printable PDF of this newsletter.

Using ICD-10 in Online Benefit Preauthorization and Referral Requests; Join Our Webinars
ICD-10 affects more than just claim submissions. Use of ICD-10 codes for benefit preauthorization requests is also service-date driven. Learn more in our upcoming webinars.

Weighing in Against Obesity: How BCBSTX Helps Communities and Members
Obesity is a public health crisis that dramatically impacts people’s health and well-being, along with health care costs. Estimates suggest that the U.S. annually spends nearly $200 billion on obesity-related health care expenses. See how BCBSTX is helping to fight obesity.

Sleep Study Medical Policy Update
As previously mentioned, BCBSTX has revised its medical policy governing sleep-related breathing disorders for services rendered on or after May 1. Effective immediately, and to allow sufficient time to adjust to recent changes, we are implementing a period of voluntary compliance.

2013 HEDIS^® Initiation and Engagement of Alcohol, Other Drug Dependence Results
The Healthcare Effectiveness Data and Information Set (HEDIS) is a used by more than 90 percent of health plans nationally to measure performance on important areas of care and service. Learn how BCBSTX members fared in comparison to national HEDIS averages when it comes to alcohol and other drug dependence treatment.

Notices and Announcements
In this issue, we discuss ICD-10 testing, venipunctures for hospitals and ambulatory surgery centers and reminding you that Blue Advantage HMO^SM has no out-of-network benefits. Get the details on these items and more.

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
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.