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 non-rural schedule.
- Reimbursement for respiratory equipment will be set at 108% of the fee schedule.
- Reimbursement for non-respiratory equipment will be set at 100% of
the fee schedule.
Memorial Day Closure
In observance of Memorial Day, our offices will be closed Monday, May 29, 2023.
Coding Advice – Excludes 1 Note
BCBSWY reviews claims for Excludes 1 Note instructions per the ICD -10- CM Official Guidelines for Coding and Reporting.
An Excludes 1 Note indicates that two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. Billed services with one or more diagnosis code pairs that are subject to an Excludes 1 Note will be denied.
Itilliti Webinar
Please join BCBSWY for a webinar with Itiliti and ACAP on June 1, 2023 at noon. You do not need to be an ACAP member to register. All BCBSWY providers are encouraged to attend.
BCBSWY and ACAP will discuss how BCBSWY has reduced the burden of prior authorizations within the company and for providers. Please register using the button below.
Register Here
Directory Provider Directory Tool Reminder
Reminder: You can now find the Availity Directory Validation Training guide under the Provider Resources section on the right rail of the website.
Providers can use the Directory Validation tool on the Availity Portal to find NPI and tax ID combinations.
The No Surprises Act (NSA) requires you confirm this information with us every 90 days.
Visit Now
Timely Filing Reminder
BCBSWY would like to remind providers we have a timely filing deadline of one year from the date of service. However, some groups have a deadline of less than a year. Therefore, we encourage providers to submit claims within 60 days of the date of service as timely filing may impact benefit determination.
Bill Claims Individually
BCBSWY does not accept roster billing. All claims must be submitted individually.
Holiday Closure
Our offices will be closed on Monday, July 4 in observance of Independence Day.
Call Center Hours Changing in June
Blue Cross Blue Shield of Wyoming (BCBSWY) provider call center hours will soon change. The new hours will be from 7:30 a.m. to 5 p.m. This change will be in effect June 1, 2022.
BCBSWY Increasing Claims Process Accuracy
In an ongoing effort to ensure high quality claims processing and payment, BCBSWY is taking additional steps to verify the accuracy of payments made to our contracted facilities. Beginning in July 2022, BCBSWY will begin auditing DRG claims and associated medical records to ensure payments were applied in accordance with national correct coding standard rules.
BCBSWY has contracted with Cotiviti to assist us in this effort. If you have DRG claims selected for audit, you will receive a letter from Cotiviti requesting medical records for these claim audits on behalf of BCBSWY.
The Provider Directory Validation Tool is Ready
In order to help facilitate compliance with the No Surprises Act (NSA) provider directory validation requirements, BCBSWY has developed a Directory Validation tool on the Availity Portal.
This tool allows you to review and confirm name, address, contact information, and providers affiliated with your organization online. The NSA requires you confirm this information with us every 90 days so your information can continue to be listed in our public directory. Please see the guide here.
Redirection of Care
Blue Cross Blue Shield of Wyoming is introducing a new redirection of care program for certain medications. When clinically appropriate services will be authorized in the most cost-effective setting, such as an Infusion Center, providers office, or via Home Health. If needed, BCBSWY will assist members with finding an appropriate site for care.
Please note, redirection of care does not affect your patient’s prescription drug benefits.
If a member is affected by this program, it will be noted in the authorization letter.
Who is Impacted:
As of January 1, 2022, the list below are the medications that will be subject to the redirection of care program for administration in the most cost-effective setting:
| Neulasta | Remicade |
| Avastin | Rituxab |
| Herceptin | Keytruda |
| Ocrevus | Opdivo |
| Somatuline | Soliris |
This program will go into effect with new prescriptions or upon authorization renewal. Typically, medical authorizations expire one year from the date of the authorization.
Questions:
We have a Redirection of Care Team. If you’re currently taking one of these medications and have questions or concerns, please call 307-823-6095.
Upcoming Holiday Closures
BCBSWY will be closed on Friday, December 24 and Friday, December 31 in observance of the Christmas and New Year holiday.
Provider Directory
Beginning Jan. 1, 2022, provider directory information must be reviewed and validated every 90 days, in accordance with the No Surprises Act. The information we’ll be looking for includes name, address, specialty, telephone number, and digital contact information of each health care provider or health care facility. Very soon, BCBSWY will share information on a new tool available in Availity to validate this information.
COVID-19 Vaccine Codes Updated
BCBSWY recently updated our COVID-19 vaccine codes to include pediatric vaccine codes. To review this information, click here.
Reminder! BCBSWY Member ID Cards
BCBSWY Member ID cards now include the amount of the in-network and out-of-network deductibles and out-of-pocket maximums. Subscriber numbers have not changed, however, please note that BCBSWY Members may offer their new Member ID card at their next medical appointment.
Upcoming Holiday Closures
BCBSWY will be closed on Thursday, November 25 and Friday, November 26 in observance of the Thanksgiving holiday.
BCBSWY Mailing Address:
PO Box 2266, Cheyenne, WY 82003-2266
Blue Cross Blue Shield of Wyoming is an independent licensee of the Blue Cross and Blue Shield Association
