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Essential resources for those who
provide healthcare to patients.
Last updated Monday, February 23, 2015
- Update – Pharmacy Policies (2015-009 - Posted 2/23/2015)
- Nexium® and Adderall XR® Coverage Changes (2015-010 - Posted 2/23/2015)
- 2015 Primary Care VBP Program Update (2015-011 - Posted 2/23/2015)
- Coding Coach – Monthly Coding Tips Resource
A new coding tip has been added to the Coding Coach. (Posted 2/23/2015)
- Oncology Clinical Pathways Pilot
Clarifying information and a list of medications recommended for pre-service review have been added to the Web page for this initiative. (Posted 2/23/2015)
- Radiation Therapy Management Program Grace Period Extended
Based on valuable feedback from providers participating in the RTM Program, Blue Cross and Blue Shield of Alabama will extend the RTM grace period one month. Precertification will now be required beginning April 1. See the RTM Web page for complete details and date changes. (Posted 2/23/2015)
- Gap in Care Dispute Form
A Gap in Care Dispute form is now available online. This form allows you to dispute open gaps in care (i.e., member had mastectomy and should be excluded from breast cancer screening measure) that you feel are erroneous for your patients. Complete the form and fax it to 1-855-344-7461 (toll-free) or 1-205-733-7461 (local) along with sufficient medical records to substantiate the dispute(s) in question. The dispute(s) will be reviewed by a group of medical coders.
If you have any questions, contact your Provider Network Services Representative at 1-866-904-4130.
Note: For Blue Advantage® gap in care disputes, use the Patient Health Snapshot (PHS).
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CPT codes, descriptions and other data only are copyrighted © 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS apply.
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