Recent Oncology Related News
• NASCO conducting payment recovery for all accounts including MOS and excluding FEP and ITS HOST
• Telehealth billing changes and new telehealth FAQ document
• Blue Cross PPO commercial claims for out-of-state Blue Cross PPO members may have processed incorrectly
• Register for the June PGIP quarterly meeting today
• Blue Cross offering virtual care options for members and convenient ways to get their prescriptions filled
• Specialist value-based reimbursement update
• Medicare Part B medical specialty drug prior authorization list is changing in June
Details >Publications
• The Record
• BCN Provider News
Details >Monthly Status Report
Many updates/corrections. Listed below is a sampling of what you will find:
• 835 Recoupment isn't reflected on voucher
• Evaluation and Management services claims are incorrectly being denied
• J0881 and J0885 claims are being denied incorrectly
• RHC claim issues
• and more
Details >
Last Updated 5/20/2020
Review the reported payer reimbursement issues MSHO is currently addressing including the response from BCBSM regarding reimbursement by NDC which is still being investigated! We also need additional Medicaid examples!!
Details >Recent Oncology Related News
Medicaid Updates Include:
• MSA Bulletin Updates
• Biller "B" Aware Notices
Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network Bulletin
• UHC Medical Policy Update
Details >Featuring this month: Medicare Advantage Plans
Tidbits regarding:
• Telehealth Requirement
• Switching Between Traditional and Advantage Plans
• Switching Prescription Plans
Details >• Financial relief for members and employers in response to COVID-19
• Collecting copays from Medicare Advantage members
• Medical policy updates
• Prophylactic Cancer Risk Reduction Surgery - 91508
• Updated process for peer-to-peer reviews starts July 1
• Commercial formulary changes coming July 1, 2020
• Biosimilars preferred over Herceptin, Avastin and Rituxan, effective July 1
Details >