As of 6/18/20 this communication has been updated with changes in red.
We’d like to update you on the steps we are taking to keep our members, our employees, and our entire community healthy and safe. Our community well-being is central to our purpose and our top priority is to help you offer the health care our community needs.
Within our company, we’re monitoring federal, state, and local advisories to guide us in making decisions about our day-to-day operations.
- Effective March 16, 2020 many BCBSWY employees are teleworking and we’re operating at reduced capacity.
- Availity is the best option to work electronically with us – you can verify eligibility and benefits, files claims, check claim status, request prior authorizations and find up-to-date communications
- The easiest way to reach us is by emailing firstname.lastname@example.org
- Rest assured, providers can expect to continue to receive timely claims payments. If the situation
- changes, we’ll be in direct contact to let you know what options are available.
Updated Telemedicine Guidance
As an emergency measure, in response to the spread of COVID-19, Blue Cross Blue Shield of Wyoming is adjusting its telemedicine policy to allow for telephonic and telemedicine visits at the patient’s home. We understand that COVID-19 has inhibited our members’ ability to seek care through normal channels, whether that care is directly related to COVID-19 or not. In order to facilitate social distancing and help alleviate concerns about access to care, this policy will be reviewed and updated throughout the pandemic.
BCBSWY will permit telephonic and telemedicine visits to occur to the patient’s home when the following conditions are met:
- The services provided are within the provider’s scope of license.
- Telecommunications technologies utilized must comply with applicable federal and state legal requirements of health/medical information privacy, including compliance with HIPAA.
- Services must be medically appropriate to be rendered at a distance.
- Providers should bill the service that they render with a GT modifier.
- Physical therapy, occupational therapy, and speech therapy should bill without the GT modifier.
- 99441, 99442, and 99443 will be permitted for telephonic visits. No GT modifier is required for these codes.
- These guidelines apply only to BCBSWY members. Providers should seek guidance from other Blues plans for potential changes to their policies.
- These guidelines do not apply to members of the Federal Employee Program.
- Other benefit and cost share rules will continue to apply. Effective 6/18/20, BCBSWY will waive cost share on all telemedicine services through 8/31/20.
- It is important to note that only services that can be rendered through telemedicine should occur. Services that cannot be safely or adequately provided through this means should be avoided.
- BCBSWY will waive any cost-sharing, including co-pays, deductibles and co-insurance for CDC- recommended laboratory testing of COVID-19 so that the cost-sharing does not serve as a barrier to access these important tests.
- In addition, BCBSWY will also waive cost-sharing for an in-network provider office visit, urgent care center and emergency room visit when testing for COVID-19. This is regardless of diagnosis.
- Subsequent hospital stays associated with COVID-19 will be covered in accordance with the member’s current health benefit plan. Effective 4/1/20-8/31/20, BCBSWY is waiving all member cost sharing and copayments for inpatient hospital admissions due to the diagnosis of COVID-19 for all fully insured and FEP members and is optional for self-funded plans.
- Effective March 10, BCBSWY is increasing access to prescriptions by allowing pharmacies to refill prescriptions earlier than typically allowed. In addition, most plans allow members to fill maintenance medications for up to a 90-day supply through local or mail-order pharmacies.
- To ensure members have the medications they need on hand, BCBSWY now allows pharmacies to waive “refill too soon” limits on prescriptions.
- Get email updates! Ask to be added to receive Provider Updates at email@example.com
Thank you for your ongoing partnership during this outbreak. We will continue to share updated information as this develops. Please contact your Provider Relations team with any questions regarding this rapidly changing situation: firstname.lastname@example.org