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Blue Bulletin

BlueShield of Northeastern NY strives to provide our network of provider practices and facilities with the most current health plan information in a quick and easily accessible manner.

  • Fee Schedule Update for July 2020

    March 27, 2020

    On July 1, 2020, our fee schedule and rates will be updated to better align with the market and standards set by Centers for Medicare & Medicaid (CMS). Here you can review upcoming changes and access current fee schedules as well as those in effect on July 1, 2020. To make it easier for you to find what you need, we’re separating the fee schedule into two sections – “Primary Care” and “Other” (encompassing all other specialty and provider types.)
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  • Claims Submissions and Adjustments

    March 27, 2020

    To allow for faster and more accurate processing, we are encouraging offices to submit claims electronically. Here is guidance for electronic claims submission and adjustments.
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  • Q1 2020 Updated Drug Therapy Guidelines Available Online

    March 27, 2020

    More than seventy-five drug therapy guidelines were recently added or updated with a committee of local physicians, other prescribers, and pharmacists. Changes to existing Drug Therapy Guidelines will be posted on our website by April 1 and will be effective May 1.
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  • Improving Colorectal Cancer Screening Rates

    March 27, 2020

    While multiple medical and scientific panels recommend colorectal cancer screening, one in three Americans between the ages of 50 and 75 have never been screened as suggested. Here we offer alternate testing options that may help your patients complete this important health screening.
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  • 2020 Population Health Management

    March 27, 2020

    To allow for faster and more accurate processing, we are encouraging offices to submit claims electronically. Here is guidance for electronic claims submission and adjustments.
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  • CMS Expands Medicare Telehealth Policy

    March 26, 2020

    We are supporting the Centers for Medicare and Medicaid Services (CMS) 1135 waiver to expand Medicare telehealth services for your BlueShield patients. This includes allowing you to conduct Annual Wellness Visits (AWVs) on your Medicare Advantage patients through non-HIPAA compliant platforms until CMS revokes the 1135 waiver.
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  • Accredo is Our New Specialty Pharmacy

    February 20, 2020

    Beginning April 1, 2020, Accredo will become our preferred provider of specialty medications. Accredo will replace CVS in providing these specialty medications for your BlueShield patients. Here we outline the process for transitioning self-administered and in-office medications
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  • Ensuring Timely Secondary Insurer Payments from BlueShield

    February 20, 2020

    Electronically submitting Coordination of Benefits (COB) claims can ensure that they are processed quickly and efficiently. Here we also offer guidance on how to submit electronic Medicare crossover claims when we are the secondary insurer.
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  • Annual HEDIS Campaign

    February 20, 2020

    February begins our annual HEDIS Medical Record Review campaign. As we do every year, we will be requesting medical records to support the care you provide to your BlueShield patients.
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  • Update to Drug Therapy Guidelines for Stelara and Rituximab

    February 20, 2020

    Updated drug therapy guidelines for Stelara and Rituximab will be posted by March 1, 2020 and effective on April 1, 2020.
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