Provider Updates

Provider News Category: E-Bulletin

Workflow and Updated Prior Authorization Guide Available
Online Prior Authorizations Submissions are unavailable until 9/18. Soon you can experience: More real-time information; Reduced wait times; Auto-approval of some authorizations. We appreciate…
Prior Authorization Update Soon
Online Prior Authorizations Submissions will be unavailable between 9/1 – 9/18. Coming soon: View more real-time information Reduced wait times Auto-approval of some authorizations…
Availity/Prior Authorization Update
Our new Prior Authorization tool, Predictal, will launch September 5th. We look forward to the convenience it will offer you. We will provide you…
Claim Reprocessing Requests; Mental Health and Substance Abuse
Claim Reprocessing Requests As we enter our busy season, we want to remind providers that if you receive a claim that is denied for…
Infusion Pump Billing, Unclassified HCFA Unit Billing
Coding Advice Infusion Pump Billing BCBSWY is seeing an uptick in billing of implantable infusion pumps (HCPCS Code E0782) billed without a required modifier…
Transition Faxes to Availity, Electronic Claim Corrections, Welcome North Platte Valley Medical Center
Transition Faxes to Availity Starting in July of 2023, we will no longer accept faxes from Providers. Please use the Availity attachments tool to…
Hearing Aid Submissions, New Prior Authorization Tool Coming in Fall
Hearing Aid Submission Effective 7/1/2023, BCBSWY will reimburse hearing aids at 100% of submitted invoices. Providers should bill the cost of professional services associated…
Intraocular Lenses Billing Code Change, Therapy Modifiers, Availity and More
Coding Advice – Modifiers As of 9/1/2023, BCBSWY will no longer permit the usage of modifiers CO (Occupational Therapy Assistant) or CQ (Physical Therapy…
DME Reimbursement Update
Announcements Holiday Closures BCBSWY is updating its DME reimbursement rates. Effective August 1, 2023, our DME reimbursement will be based on Medicare’s DMEPOS 2023…
New! COVID-19 Test Billing Guidance
The Families First Coronavirus Response Act (the FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act) require health plans to…
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