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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.

  • Introducing New Regional Executive Keith Dolan

    September 26, 2019

    After an exhaustive search, BlueShield of Northeastern New York has appointed a new vice president and regional executive. Capital region native Keith Dolan will fill the role. Dolan will oversee the strategic direction and operation of BlueShield, which serves more than 120,000 members across 13 counties in the Capital Region. We posed some questions to Keith about his new role.
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  • Updated Drug Therapy Guidelines Available Online

    September 26, 2019

    Our drug therapy guidelines were recently updated and will be posted to our website on October 15, going into effect November 15, 2019. The list of drugs affected by these updates is now available.
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  • Breast Cancer Awareness Month: Are Your Patients Missing Mammograms?

    September 26, 2019

    October is Breast Cancer Awareness month, which serves as a reminder to check whether any of your patients are missing this important health screening.
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  • Update to Primary Care HbA1c Management Incentive

    September 26, 2019

    The Centers for Medicare and Medicaid Services (CMS) is retiring a CPT II code for HbA1c management on October 1, 2019. We will replace this code, part of our Pay for Outcomes (P4O) program, with two new codes available for reimbursement.
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  • Advance Care Planning and Medicare Advantage Reimbursement

    September 26, 2019

    Advance care planning helps patients prepare for current and future decisions about their medical treatment and place of care. You can be reimbursed for having these discussions with your Medicare Advantage patients.
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  • An Early Start to 2019-2020 Flu Season?

    August 26, 2019

    It’s impossible to predict the exact timing or severity of the coming flu season. However, Australia’s flu season, which runs six months ahead of ours (May to October), has historically provided an accurate forecast of what’s to come in the U.S. The current Australian flu season could offer especially important insights for us this year.
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  • Confirming Preauthorization and Coding Requirements in Minutes

    August 26, 2019

    We know confirming coverage for services can take time. Our online Code and Comment and Clear Claim Connection tools provide quick and easy 24/7 access to information about preauthorization requirements, CPT and HCPCS codes and modifiers, as well as claims processing.
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  • When to Use Modifier 25

    August 26, 2019

    Clearly documenting services performed helps you get paid quickly and correctly. Modifier 25 can help when used properly.
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  • Medical Protocol and Drug Therapy Guideline Updates Available Online

    August 26, 2019

    We reviewed 58 medical protocols and will post updates online by August 30, 2019. In addition, we updated commercial pharmacy benefit coverage of Cimzia for Crohn’s Disease, effective October 1, 2019.
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  • Addressing Patient Health Literacy

    August 26, 2019

    Since 77 million adults in the U.S. have only limited health literacy, it’s important to make sure your patients understand your directions for their health and safety. We offer tips from the Agency for Healthcare Research and Quality (AHRQ).
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