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Important Dates and Reminders

Check this page often for a quick snapshot of recent implementations, upcoming changes, special events, important deadlines and other reminders. This information is also included in our monthly Blue Review newsletter. We understand that provider offices are extremely busy and, while this information should not be interpreted as all-inclusive, we hope this abbreviated summary format is useful to you and your staff.


Confirmation of Recent Implementations

Topic

Brief Description

Date Implemented:

For More Information

Claim Research Tool (CRT) Enhancement (Commercial Claims)

The CRT now returns out-of-network patient responsibility in the service line details, when applicable.

Aug. 26, 2019

New and Exciting Functionality Announcements for Claim Research Tool (CRT) via Availity® Provider Portal
(September 2019, Blue Review)

Automated Phone System Enhancements (Commercial)

Our interactive voice response (IVR) phone system will now consolidate benefit responses for services that have the same benefit details.

Aug. 26, 2019

Enhancement to Automated Phone System: Consolidated Benefit Response
(September 2019, Blue Review)

Changes to Benefit Preauthorization Requirements Through eviCore healthcare (eviCore) for Government Programs

Benefit preauthorization through eviCore is no longer required for certain government programs members for services in select care categories, such as cardiology and/or specialty therapy services.

Sept. 1, 2019

Government Programs Update: Removal of Benefit Preauthorization Requirement for Cardiology and Specialty Therapy Services, Effective Sept. 1, 2019
(September 2019, Blue Review)

 

Upcoming Changes to Watch For

Topic

Brief Description

Target Implementation Date:

For More Information

Availity Claim Research Tool (CRT) enhancements*

*CRT is not yet available for government programs claims.

Cotiviti, INC. (Cotiviti) code-auditing logic descriptions and additional action(s)/instructions will be added to the Availity CRT to help providers manage and resolve specific BCBSIL commercial claim denials.

Sept. 23, 2019

New and Exciting Functionality Coming to the Claim Research Tool (CRT) via Availity® Provider Portal
(September 2019, Blue Review)

Respond Electronically to Claim-related Medical Record Requests from BCBSIL via Availity

The Medical Attachments application will allow electronic responses to claim-related medical record requests from BCBSIL, in addition to electronic responses to quality and risk adjustment medical record requests.

After Oct. 1, 2019

Government Programs Update: Removal of Benefit Preauthorization Requirement for Cardiology and Specialty Therapy Services, Effective Sept. 1, 2019
(September 2019, Blue Review)

 

Special Events and Activities

Topic

Brief Description

Important Date(s)

For More Information

Cultural Competency and Implicit Bias Training Program

Online training modules; currently in progress for select HMO network primary care physicians.

through October 2019

Health Equity: Bold Strategies, Unique Solutions
April 2019, Blue Review)

2019 Blue Review Readership Survey

Watch for this year’s survey to provide your feedback and ideas.

October and November 2019

Information will be posted in the News and Updates once the survey is available.

Monthly Virtual Provider Workshops

Our Provider Network Consultant team will be hosting one-hour online training sessions to help keep you informed of important BCBSIL updates and initiatives.

through December 2019

Watch the Provider Learning Opportunities or visit the Webinars and Workshops page for upcoming dates and online registration.

 

Deadlines and Other Reminders

Topic

Brief Description

Important Dates

For More Information

Email Validation Survey

If you’re on our Blue Review distribution list, you may receive an email validation survey from BCBSIL.

Ongoing through 2019

We’re Conducting an Email Validation Survey
(May 2019, News and Updates)

Some of our Blue Choice Preferred PPOSM members may receive Fecal Immunochemical Test (FIT) Kits

Access Health Corporation (an independent company specializing in in-home diagnostic testing) will process tests and send results to our members and their specified primary care providers.

Members have until Nov. 15, 2019, to complete and submit their in-home colorectal cancer screening tests for processing.

In-home Colorectal Cancer Screening Test Provided to Select Members
(June 2019, Blue Review)

Government Programs Providers: Resubmit Claims Previously Incorrectly Rejected for Invalid National Drug Codes (NDCs)

BCBSIL has updated its systems per the Illinois Department of Health and Family Services (HFS); we are running reports to identify claims that rejected in error for invalid NDCs (dates of service on or after March 15, 2017).

Submit any claim previously incorrectly rejected for invalid NDCs through Availity or your preferred vendor portal by Nov. 30, 2019.

Update: Government Providers, Resubmit Claims Previously Incorrectly Rejected for Invalid NDCs
(September 2019, News and Updates)

Remind your Medicare and Medicaid patients to schedule their annual wellness visits.

Providers may increase Star ratings by promoting preventive care; participating members could receive $50 gift cards.

Before Dec. 31, 2019

CMS Star Ratings Matter: Encourage Members to Schedule Annual Wellness Visits
(September 2019, Blue Review)