2014 News and Updates
Open Enrollment: Welcoming New and Renewing Members
Pharmacy Program Updates: Pharmacy Program Changes Effective Jan. 1, 2015
ClaimsXten to Add Correct Coding Initiative Rule
Coordination of Benefits – Communication Update
Supporting Appropriate Use of Prescribed Controlled Substance Medications
Alpha-prefix Reference Guide
Submitting Electronic Replacement and/or Void Claims
Medical Record Submission 'Dos and Don'ts'
Government Reclassifies Hydrocodone Combination Products
Pharmacy Program Benefit Changes, Effective Jan. 1, 2015
In the Know: Medicare Marketing Guidelines for Providers
MUS Vision Plan Has New Hardware Vendor
Provider Contracting and Credentialing Process
Modifier 51 Clarification
Medically Unlikely Edits Rule and Orthotics Devices and Procedures
Postpone: ClaimsXten November 2014 Update
Health Care Management Services Reference Guide
New Fax Numbers for Predetermination Requests for Outpatient Services, Drugs and Devices
Medicare Crossover Claims Submission Reminder
Blue Cross and Blue Shield Plans have been using the Centers for Medicare and Medicaid Services (CMS) crossover process to receive Medicare primary claims since January 2006. The CMS crossover process routes Medicare Supplemental claims (Medigap and Medicare Supplemental) directly from Medicare to BCBSMT so that providers do not need to also submit the claim to BCBSMT.
Provider Online Services
Please review the information below for updates and new items available to our providers using the Provider Online Services. Recent changes include dental benefit summary information as well as access to your Provider Claim Summary (PCS) reports from our new processing system.
Modifier 59 Policy Changes with ClaimsXten
BCBSMT Streamlines Medical Policies Page
Tips for Using a 270 Eligibility/Benefit Request
As of Jan. 1, 2014, providers can view benefit summary information for BCBSMT members who have either converted to or are new to our new processing system. However, the benefit summary for these members is not as detailed as providers may be accustomed to seeing.