Blue Review - Blue Cross and Blue Shield of Texas

September 2015

(Electronic distribution September 2, 2015)

View a printable PDF of this newsletter.

ICD-10: Important Dates and Resource Reminders
We will begin accepting ICD-10 codes as of Sept. 21, 2015, for benefit preauthorization requests for services that will be rendered on or after Oct. 1, 2015. Valid ICD-10 codes must be included on claims submitted for dates of service or inpatient discharge dates on or after Oct. 1, 2015. Get the details.

Health Summary Now Available in iExchange®
We have enhanced our online benefit preauthorization tool, iExchange, to obtain a Health Summary. These summaries are created from claims and other data and may include member details, chronic and acute conditions, medications and much more – all delivered in near ‘real time'.

Seasonal Flu Vaccines Save Lives and Reduce Unnecessary Hospitalizations
Although most of those who become infected with influenza viruses will recover without sequelae, influenza can cause serious illness and death. Get the details on why it’s important to remind and encourage patients to seek a flu vaccination.

When Is It Time to Consider Palliative Care?
Although hospice care has existed nationally since the early 1980s, palliative care is a relatively new specialty. Most Americans have never heard of it. In this second of a three-part series, learn about a model of care that focuses on relieving or preventing suffering from “life-limiting illness.”

Medicare Marketing Guidelines for Providers
We are providing a partial list of what providers should or should not do when marketing Medicare services to potential new members. These suggestions come as the 2016 Centers for Medicare & Medicaid Services (CMS) Annual Election Period for beneficiaries approaches.

Help Your Patients Keep Their Health on Track with Our Healthy Family App
Healthy Family is an app that tells users, like your patients, which preventive services are recommended for themselves and their familes. Learn more how the app could assist your patients, and feel free to suggest they download it.

Notices and Announcements
In this issue of the newsletter, we announce that, effective Jan. 1, a certain range of codes will only allow one unit on a single date of service, that BCBSTX soon will no longer reimburse for some Category II codes and that iExchange® will soon support submission of online requests for predetermination benefits. We also provide a tutorial for using DSM-5 in the transition to ICD-10 and suggestions on what to look for in an app to assist you in transitioning to ICD-10. 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 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 PPOSM, HMO Blue TexasSM, Blue Cross Medicare Advantage (PPO)SM, Blue Advantage HMOSM 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.


 



BCBSTX makes no endorsements, representations, or warranties about any products or services offered by
independent third-party vendors mentioned in this newsletter. The vendors are solely responsible for the products or
services offered by them. If you have any questions about the products or services mentioned in this newsletter,
contact the vendor directly.


A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association.

Blue Review • September 2015 • www.bcbstx.com