Anthem is a registered trademark of Anthem Insurance Companies, Inc. If you are a Blue Cross and Blue Shield of Alabama customer and need to reach us by phone, please use the telephone number on the back of your ID card. Need help? The Local Plus plan is ideal for members who prefer the predictability of co-payments rather than using employer funding to offset out-of-pocket costs. Subscribers have until. BCBSRI is updating its standard fee schedule again for commercial and Medicare Advantage products for dates of service occurring on or after November 1, 2022. All Rights Reserved. To access your member services, please visit your BCBS company. Section 1: Network Overview - Updated 1/31/2023. | Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. This new site may be offered by a vendor or an independent third party. Section 5: Billing and Reimbursement Guidelines - Updated 1/1/2023. | Blue Cross and Blue Shield of Texas (BCBSTX) is implementing changes in the maximum allowable fee schedule for Blue Choice PPO SM, Blue EssentialsSM (including HealthSelect SM of Texas Network), Blue Premier SM, Blue Advantage HMO SM, MyBlue Health SM and PAR Plan networks (collectively referred to as "Networks") effective March 1, 2020.. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. $ 382. Additional sources are used and can be provided upon request. Keeping your mouth healthy is key to your overall health. 100748 0521 R3 Page 1 COVID-19 Provider Billing Guidelines In response to the coronavirus disease (COVID-19), we've established billing code guidelines for our Commercial, Affordable Care Act (ACA), . Stay connected with what is going on at Blue Cross with our provider newsletters. We offer a series of disease and case management programs. Substance Use Treatment & ResourcesLearn more about substance use disorders and find a treatment provider that meets your needs. Understand your plan, learn about health savings accounts, and watch helpful videos. For portal assistance call (800) 716-2299 option 3 or email EDIServices@bcbsla.com. Member Discounts Take advantage of member-only discounts on health-related products and services. Blue Cross and Blue Shield Service Benefit Plan www.fepblue.org 2021 . In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Fee schedulesBCBSILs Schedule of Maximum Allowancesare a key component of your contractual relationship with BCBSIL, and we want to help ensure that you always have the most up-to-date information. Our primary annual fee update will be effective May 1, 2021. If you have questions regarding fee schedules, contact your provider liaison or call Provider Partnerships at 602-864-4231 or 1-800-232-2345, ext. In the event of conflict between a Clinical Payment and Coding Policy and any plan document under which a member is entitled to Covered Services, the plan document will govern. Out-of-network care is provided in emergencies only. Evaluation & Management services The specific changes and effective dates for the Network fee schedules and files are posted on the BCBSTX provider website under the Standards & Requirements tab then select General Reimbursement Information. More Information, English | Whether you want to quit smoking or find the right doctor, we have many programs to help. If there is a difference between any policy and the Members plan of benefits or Certificate of Coverage, the plan of benefits or Certificate of Coverage will govern. Clinical payment and coding policies are based on criteria developed by specialized professional societies, national guidelines (e.g. Read the Requirements Electronic Services Access electronic services including iLinkBlue, online authorizations and more. We have partnered with Lucet for their expertise in the provision of mental health services. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly. Ting Vit | The reimbursement policy affects Anthem's commercial and Medicare Advantage insurance products in states such as Alaska, California, Indiana, Missouri, and Ohio. Blue Cross and Blue Shield of Louisiana, an independent licensee of the Blue Cross Blue Shield Association, offers Blue Advantage (PPO). Type at least three letters and we will start finding suggestions for you. Interested parties may contact the Records Division on (269) 385-6191 to verify if the report of interest is available. Leading the way in health insurance since 1929. You can count on our affordable plans and extensive networks no matter what part of Louisiana you call home. Learn more about what's covered and what's available to you on your new health plan. Coding resources Coding types and sources Coding Blue Cross and Blue Shield of North Carolina provides fee schedule information to participating physicians electronically. Pilipino | Copyright document.write(new Date().getFullYear()) Health Care Service Corporation. The actual impact to any particular provider will depend on the codes most frequently billed by that provider. If you just found out that you need surgery, or if you will be admitted to a hospital or ambulatory surgical center for any reason, you will most likely receive some care during your stay from a hospital-based physician. Milliman Care Guidelines (MCG) and the CMS Provider Reimbursement Manual. Click below to search for Hospitals or Medical Providers in the Vantage Network. A Fee-For-Service Plan (FEP Blue Standard and FEP Blue Basic Options) with a Preferred Provider Organization . Blue Cross Blue Shield of Arizona (BCBSAZ) fee schedules are based on a number of pricing sources that can influence the need for changes. Find information and requirements for managing services to members. Find my BCBS company. App Store is a service mark of Apple Inc. Google Play is a trademark of Google Inc. Federal Employees: 1-800-492-8872 Aug 1, 2020 Administrative. Log in to your online account to view and download a digital version of your Blue Cross member identification card. National Drug Code (NDC) Reimbursement Schedule Visit Blue365. See your choice of network doctors and specialists without a referral. | With Blue Advantage (HMO) | Blue Advantage (PPO), you get Medicare coverage, plus so much more. BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors such as Availity. Blue Advantage from Blue Cross and Blue Shield of Louisiana HMO is an HMO plan with a Medicare contract. The updated fee schedule will be available on the Availity Portal* on the effective date of January 1, 2021. Enrollment in either Blue Advantage plan depends on contract renewal. | Read documents about clearninghouse services, claims, remittance and other services. | Availity provides administrative services to BCBSIL. The site may also contain non-Medicare related information. CPT copyright 2021 American Medical Association (AMA). | Applicable modifiers on claims for behavioral health services . External link You are leaving this website/app (site). Pick a directory to search or find other helpful information about drug resources, quality programs and more. This new site may be offered by a vendor or an independent third party. You can preview the updates on the secure provider portal starting April 1, 2021. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Future fee schedule updates will continue to be communicated via Provider Notify emails and Provider News, according to contractual agreements. This new site may be offered by a vendor or an independent third party. The 34 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico. The site may also contain non-Medicare related information. Keep in mind that determination of coverage under a member's benefit plan does not necessarily ensure reimbursement. Refer to the Member's plan of benefits or Certificate of Coverage to determine whether coverage is provided or if there are any exclusions or benefit limitations applicable to any of these policies. As part of our commitment to help inform our independently contracted providers of certain developments, Blue Cross and Blue Shield of Illinois (BCBSIL) has designated a specific section in the Blue Review to notify you of any significant changes to the physician fee schedules. Electronically submit and manage requests for services and procedures. We can help you find the right coverage for your needs. Thanks for heroic efforts on COVID-19 fronts, Annual HEDIS medical records retrieval begins, May 1: Annual update of BCBSAZ fee schedules, Claim prep guidelines and required data elements, Engage patients in diabetes self-management. Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc., an independent licensee of the Blue Cross and Blue Shield Association. We can help you find the right coverage for your needs. Information current and approximate as of December 31, 2018. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Get discounts on gym memberships, fitness gear, healthy eating, prescriptions and more. Aetna Waived 4-Jun Teladoc options through the Aetna Health app; Network providers who deliver virtual care, such as live video - conferencing; and other virtual Blue Advantage from Blue Cross and Blue Shield of Louisiana is a PPO plan with a Medicare contract. Select a Region: Please Select One DVEST1 DV9ST1 DV8ST1 DV5ST1 DV4ST1 DV1ST1 DVPST1 DVOST1 DVMST1 DVJST1 DVHST1 DVGST1 DVFST1 DVEST1 DVDST1 DVCST1 LOEST1 Only users with an active user ID and password who currently use Blue Access for Providers to view the National Drug Code Reimbursement Schedule should take these steps between May 2 and June 30, 2022, to maintain your existing password: If you dont take these steps, youll need to reset your password after June 30. Reimbursement Policies | Healthy Blue Louisiana Reimbursement Policies We want to assist physicians, facilities and other providers in accurate claims submissions and to outline the basis for reimbursement if the service is covered by a member's benefit plan. You can rely on the strength of the Cross and the protection of the Shield. Each organization must pick a representative to manage access to our secure online services. Children diagnosed as obese may be eligible for benefits from Blue Cross. Blue Cross and Blue Shield of Louisiana is licensed to sell products only in the state of Louisiana. One option is Adobe Reader which has a built-in reader. To live free of worry, free of fear, because you have the strength of Blue Cross Blue Shield companies behind you. Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. * Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid. Blue Cross, Blue Shield, the Cross and Shield Symbols, MyBlue, BlueCard, Federal Employee Program, and FEP are registered service marks, and BluePathway is a service mark, of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. 2021 Blue Cross Blue Shield of Arizona, Inc. All rights reserved.Apple, the Apple logo, iPad, and iPhone are trademarks of Apple Inc., registered in the U.S. and other countries. Please select the option that best fits your plan type. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Search for meal delivery, transportation, job training and other services near you. Prescription drug coverage options with no deductible. External links open in new windows to websites Blue Cross and Blue Shield of Louisiana does not control. Medical Policies and Clinical UM Guidelines, Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Explanation Of Payment (EOP) Policy Crosswalk. An email address is required in the space below. Industry practices are constantly changing, and Healthy Blue reserves the right to review and revise policies periodically. | All rights reserved. Please complete the information below to request a fee schedule. Services should be billed with CPT codes, HCPCS codes and/or revenue codes. Use of the Anthem websites constitutes your agreement with our Terms of Use. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Blue Cross Blue Shield of Arizona (BCBSAZ) fee schedules are based on a number of pricing sources that can influence the need for changes. Blue Advantage from Blue Cross and Blue Shield of Louisiana HMO is an HMO plan with a Medicare contract. | Please note that as a Blue Advantage member, you must continue to pay your Medicare Part B premium. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. We are also pleased to welcome new providers on board. The site may also contain non-Medicare related information. Search professional fee schedule We value our business relationships with each and every one of the providers who are already participating in ourPreferred Provider Option (PPO), Blue Choice PPOSM, Blue Choice PreferredSM, Blue Choice SelectSM, and Blue High Performance Network(BlueHPN)networks. We work with doctors, hospitals and clinics around Louisiana to make sure you have a better healthcare experience. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, Anesthesia Clinical Payment and Coding Information, Coordinated Home Care/Private Duty Nursing, Drug Testing Clinical Payment and Coding Policy, Evaluation and Management (E/M) Services Coding Facility Services, Evaluation and Management (E/M) Coding Professional Provider Services, Increased Procedural Services (Modifier 22), Intraoperative Neurophysiology Monitoring Coding and Reimbursement Guideline, Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy, Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU), Observation Services Tool for Applying MCG Care Guidelines Clinical Payment and Coding Policy, Outpatient Facility and Hospital Claims: Revenue Codes Requiring CPT or HCPCS Codes, Paravertebral Facet Injection Procedure Coding & Billing Policy, Point-of-Care Ultrasound Examination Guideline, Psychological and Neuropsychological Testing, Therapeutic, Prophylactic and Diagnostic Injection and Infusion Coding, Unlisted/Not Otherwise Classified (NOC) Coding, Wasted/Discarded Drugs and Biologicals Guideline. Ting Vit | Blue Cross and Blue Shield of Louisiana HMO offers Blue Advantage (HMO). Now is the time to find the right Medicare plan that fits your changing healthcare needs. Were making Blue Access for Providersmore secure. Healthy Louisiana plans require behavioral health providers to bill according to the Medicaid In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Blue Cross and Blue Shield of Louisiana, an independent licensee of the Blue Cross Blue Shield Association, offers Blue Advantage (PPO). A drug list* is a list of prescription drugs your health plan covers. To access your member services, please visit your BCBS company. General reimbursement information policies and fee schedule information will be posted under "Reimbursement Changes/Updates" in the "Reimbursement Schedules" section. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Please note that files will be pulled. Our plans combine medical, hospital and prescription drug coverage in one convenient and affordable plan. Blue Cross and Blue Shield of Louisiana, an independent licensee of the Blue Cross Blue Shield Association, offers Blue Advantage (PPO). Our new Blue Advantage Provider page is designed to give you access to the most current Blue Advantage resources. Our plans combine medical, hospital and prescription drug coverage in one convenient and affordable plan. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. Professional providers participating in our Preferred Provider Option (PPO), Blue High Performance NetworkSM (BlueHPNSM) and Blue Choice PPOSM networks may use the Fee Schedule Listing tool on Availity Essentials to submit electronic requests and receive the contracted price allowance for specific codes. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. Codes: CPT Description; Unit LBA: SCABA TECH: 97151. Booster shots are not included. We require credentialing for both professional and facility providers. These include Medicare fee schedules, information derived from claims, competitive pricing data, and feedback from BCBSAZ network providers. There may be times when these policies are superseded by state, federal or CMS requirements. All the drugs on our drug lists have been approved by the U.S. Food and Drug Administration. Contracted providers may obtain the NDC Reimbursement Schedule through Blue Access for ProvidersSM. Here's what you need to know about this change. For CPCPLAB policies, refer to theLaboratory Benefit Management Programpage. Every year, Medicare evaluates plans based on a 5-star rating system. In the event of conflict between a Clinical Payment and Coding Policy and any provider contract pursuant to which a provider participates in and/or provides services to eligible member(s) and/or plans, the provider contract will govern. All are independent licensees of the Blue Cross Blue Shield Association. Toothpic is a tele-dentistry app which triages members Certain policies may not be applicable to Self-Funded Members and certain insured products. Reference Section - Updated 1/1/2023. . | Deutsch | With Blue Advantage (HMO) | Blue Advantage (PPO), you get Medicare coverage, plus so much more. Picking a primary care doctor is an important step to staying healthy and saving money. All Rights Reserved. Please fax the completed form to (716) 887-2056, along with your Certificate of Liability Insurance. Find a doctor near you or search for other doctors in Louisiana and more. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. 107. IMPORTANT Rates: Back Cover Changes for 2021: Page 15 Summary of Benefits: Page 163 Provider Enrollment Form . BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. . Search Express Scripts network for a retail pharmacy. The State Health Plan dental and health fee schedules are available to download in Excel file formats. Blue Distinction Centers are part of a national designation program that recognizes hospitals that demonstrate expertise in delivering quality specialty care safely and effectively. Use BlueCare to schedule an online visit with a licensed therapist. Most PDF readers are a free download. Blue Cross and Blue Shield of Louisiana, the largest health insurance provider in the state, expects to offer credits on health care policy premiums totaling $26.7 million across tens of. BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Save this page to your browser favorites to easily access iLinkBlue going forward. Section 4: Medical Management - Updated 1/31/2023. Providers | Blue Cross and Blue Shield of Louisiana | Home Network Enrollment Learn more about our network requirements and credentialing program. If your ID card is not available, you may use one of the Customer Service telephone numbers below. March 2023 Anthem Provider News - Kentucky, February 2023 Anthem Provider News - Kentucky, New ID cards for Anthem Blue Cross and Blue Shield members - Kentucky, Telephonic-only care allowance extended through April 11, 2023 - Kentucky, January 2023 Anthem Provider News - Kentucky, November 2020 Anthem Provider News - Kentucky. Benefits will be paid according to the fee schedule for PMLs. Blue Cross and Blue Shield of Louisiana Enters Into Definitive Agreement to be Acquired by Elevance Health, Deal will result in $3 billion foundation focused on improving Louisiana. To view this file, you may need to install a PDF reader program. Y0132_23-205_MKLA - Last Updated 01/05/2023. Blue Advantage from Blue Cross and Blue Shield of Louisiana is a PPO plan with a Medicare contract. Most PDF readers are a free download. R13368-B_Provider Enrollment Form Rev 10/1/21 . BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors and the products and services they offer. Choose new challenge questions and answers when prompted. Follow the links. Anthem Blue Cross and Blue Shield (Anthem) recently notified members of the upcoming changes to its Anthem Plan Fee Schedules, scheduled to take place July 1. Blue Cross and Blue Shield Professional Fee Schedule Request To request a copy of your Blue Cross and Blue Shield of Minnesota professional fee schedule, please complete this form and submit via email to: Fee_Schedule_Allowance_Request@bluecrossmn.com This plan offers $25 primary care co-pays and $50 specialty care co-pays. The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers. Enrollment in a Blue Advantage plan may be limited to specific times of the year. Effective January 1, 2021, Anthem Blue Cross and Blue Shield Medicaid (Anthem) will update the Reference Laboratory Fee Schedule for Anthem. Name Florida Blue Number National Provider Identifier (NPI) Mailing Address City State Zip Street Address City State Zip Telephone Number ( ) Fax Number ( ) Healthy Blue is the trade name of Community Care Health Plan of Louisiana, Inc. an independent licensee of the Blue Cross and Blue Shield Association. Manage user access to our secure online services. Milliman Care Guidelines (MCG) and the CMS Provider Reimbursement Manual. Providers and facilities are required to use industry standard codes for claim submissions. To access this area, please obtain the password from your Network Management Office. Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). Starting in Mid-July, when Anthem notifies you of a statewide fee schedule update or provider contract amendment, you can log into Availity.com and download a digital copy of your content.. Over the last few months, we have been tirelessly working to improve our service . Our SmartShopper tool lets you compare the costs of common medical procedures based on price and location. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, To review BCBSILs Schedule of Maximum Allowances for PPO and Blue Choice PPO providers, you must submit a, Significant changes to the physician fee schedules are included in the, Specific code changes and annual and quarterly fee schedule updates can be obtained by downloading and submitting a, Professional providers participating in our PPO and Blue Choice PPO networks may use the. On Jan. 1, 2023, BCBSIL will implement Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) procedure code additions, deletions and revisions. In Ohio: Community Insurance Company. Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health Service & Indemnity Company. Access electronic services including iLinkBlue, online authorizations and more. Where you go and who you see for treatment is a big part of getting quality healthcare while saving money. Electronically send your submissions to Blue Cross. We can help you get coverage. We offer three Traditional plans and three Certified plans to meet your needs. Our fee schedule is being updated to better align with the market and standards set by Centers for Medicare & Medicaid Services (CMS). Summary of Privacy Practices Notice & Member Data Protection Statement, Notice of Non-Discriminatory Practices & Multi-Language Interpreter Services. Call our Internet Help Desk at 888-706-0583. Find a Plan Get Free Kit Turning 65 or new to Medicare? More specifically, BCBSRI's 2021 fee schedule is based on the 2020 RIMFS for the vast majority of codes/services. In Maine: Anthem Health Plans of Maine, Inc. Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. LOUISIANA MEDICAID APPLIED BEHAVIORAL ANALYSIS FEE SCHEDULE Effective for Dates of Service on or After July 1, 2022. 4231. Blue Cross and Blue Shield of Texas (BCBSTX) is implementing changes in the maximum allowable fee schedule for Blue Choice PPOSM, Blue EssentialsSM (including HealthSelectSM of Texas Network), Blue PremierSM, Blue Advantage HMOSM, MyBlue HealthSM and PAR Plan networks (collectively referred to as "Networks") effective March 1, 2020.
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