Our Blue Review provider newsletter is released monthly so that you and your staff have the latest news on claims and billing, federal mandates, medical policies, condition management programs, practice guidelines, formulary/drug list updates, Medicaid, BlueCard, and educational webinars.
Additional Resources:
June 2024 — Read these articles and more...
- Reminder: Use New Mailing Address
- Important Updates to Manage My Organization in Availity® Essentials
- New Mexico House Bill 27: Breast Exam Health Coverage
- Electronic Claim Review and Ensuring the Correct Use of our Claim Review Form
- ClaimsXtenTM Quarterly Update Effective Aug. 19, 2024
- Helping Our Members Manage Diabetes
- Updated PEAQSM Methodology Is Now Available
- Clinical Payment and Coding Policy Updates
- Behavioral Health Consultations During Hospitalization Can Improve Outcomes
- Pharmacy Program Quarterly Update Changes Effective July 1, 2024 — Part 1
- Closing Gaps in Care for Group Medicare Advantage (PPO) Members
- RSVP for the 2024 Turquoise Care Provider Training Sessions
- Medicaid Transition to Turquoise Care on July 1, 2024
- Turquoise Care Provider Reference Manual
May 2024 — Read these articles and more...
- Updates made to the Provider Reference Manual
- Reporting Requirements for Providers Supplying Diabetic Supplies, Equipment and Prescriptions
- Avoid Directory Suppression: Update your Directory Information such as Accepting New Patients
- Late and Added Charges Must Be Submitted as a Corrected Claim
- 2024 Billing/Documentation Guidelines for Urine Drug Tests
- Prior Authorization Updates
- Coding Webinars: Arrhythmias and Rheumatoid Arthritis
- Supporting Maternal Quality Care
- Clinical Payment and Coding Policy Updates
- Filing Claims for Behavioral Health Services — Use the Correct Place of Service Code
- Pharmacy Program Quarterly Update Changes Effective April 1, 2024 — Part 2
- Updates Made to the Medicare Advantage Provider Reference Manual
- Prior Authorization Updates for Medicare Advantage
- Updates Made to the Provider Reference Manual for Blue Cross Community Centennial
- 2023 Medical Record Review
- Updated: BCBSNM New Process Regarding Legal Responsible Individuals as Caregivers
April 2024 — Read these articles and more...
- Change Healthcare Cybersecurity Incident Impact
- ClaimsXten™ Quarterly Update Effective June 17, 2024
- See Our Revised Clinical Payment and Coding Policy for Anesthesia Services
- Clinical Payment and Coding Policy Updates
- Caring for Substance Use Disorders
- Webinar on Coding for Medicare Advantage Annual Wellness Visits
- Medicare Advantage Coverage of Skilled Nursing Care and Skilled Therapy Services
- RSVP for 2024 Annual Medicaid Provider Training Sessions
- EPSDT Insights & Provider Participation
- Increasing Access to Health Care One Care Van Visit at a Time
- BCBSNM Breaks Ground on Blue Door Neighborhood CenterSM
March 2024 — Read these articles and more...
- Reminder: Update Your Records with New Mailing Addresses for Paper Claims
- Updates made to the Provider Reference Manual
- Federal Employee Program Updates to Prior Approval Requirements and Benefits
- Closing Gaps in Colon Care
- Clinical Payment and Coding Policy Updates
- Follow-up Care for Mental Health
- Avoiding the Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
- Pharmacy Program Quarterly Update Changes Effective April 1, 2024 — Part 1
- Medicare Advantage HEDIS Records Collection through June 2024
- Updates Made to the Blue Cross Community Centennial Provider Reference Manual
- Blue Cross Community Centennial Members Rate Their Experience
- Blue Cross Community Centennial Quality Improvement Program
- New Mexico Medicaid Team Provides Prenatal Outreach to High-Risk Mothers
February 2024 — Read these articles and more...
- Changes Coming to Claim Inquiry Resolution — High-Dollar, Pre-Pay Reviews Only
- Provider Onboarding Process Update
- Blue Cross and Blue Shield Federal Employee Program® HEDIS® Records: Collecting February through April 2024
- Join Our Quality Improvement Committee: Provider Opportunity at BCBSNM
- 2023 Annual HEDIS Medical Record Review Begins February 2024
- Prior Authorization Updates
- ClaimsXtenTM Quarterly Update Effective April 15, 2024
- Coding Webinars: Major Depressive Disorder and Annual Wellness Visits
- Utilization Management: How to Avoid Delays and Denied Claims
- Managing Antidepressant Medication
- Supporting Healthy Hearts
- Clinical Payment and Coding Policy Updates
- Appropriate Use of Opioids Program to be Retired January 2024
- Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2024 — Part 2
- Prior Authorization Updates for Medicare
- Centers for Medicare and Medicaid Services guidelines for Availability and Access Standards to Care for Medicare Advantage Members
- BCBSNM New Process Regarding Legal Responsible Individuals as Caregivers
- New Mexico Kids Matter Receives Grant from BCBSNM to Support Teens in Foster Care
January 2024 — Read these articles and more...
- Reminder: Update Your Records with New Mailing Addresses for Paper Claims
- Updates made to the Provider Reference Manual
- Advisory on Telemedicine Services — Using Place of Service Codes on Commercial Claims
- Prior Authorization Updates
- Three New ClaimsXtenTM Rules to be Implemented March 2024
- Reminder: See Updates to Claim Editing Changes for Emergency Department Services
- Clinical Payment and Coding Policy Updates
- Monitoring Children Using ADHD Medication
- Remind Our Members about Cervical and Breast Cancer Screenings
- Oral Oncology Pharmacy Network Transitioned to IntegratedRxTM
- BCBSNM’s Approach to Managing GLP-1 Agonist Medications
- Updates Made to the Blue Cross Medicare Advantage Provider Reference Manual
- Prior Authorization Updates for Medicare
- Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
- Hospitals Must Provide Medicare Outpatient Observation Notice
- Update Your Records: New Medicare Open Access PPO Members and ID Cards
- Updates Made to the Blue Cross Community Centennial Provider Reference Manual
- Zuni Youth Enrichment Project Receives Grant from BCBSNM to Improve Health Outcomes for Zuni Residents