Blue Cross Announces Changes
Physicians contracted with Blue Cross should be aware of three important issues.
1. Blue Cross Fee Schedule Changes Take Effect January 1. Anthem Blue Cross notified physicians of changes to its Prudent Buyer physician fee schedule that will take effect January 1, 2010. Blue Cross informed physicians that it would be modifying payment levels for many CPT codes, some being increased and others decreased. The new rates are available at the Blue Cross website or by calling Provider Relations at 800/933-6633. If you do not agree with proposed changes, you can terminate the contract anytime before November 11. Termination letters can be mailed to Anthem Blue Cross, Prudent Buyer Plan Contract Processing, Mail Station 8A, P.O. Box 4330, Woodland Hills, California 91365-4330. The CMA and ACCMA have tools to assist physicians estimate the financial impact of fee schedule changes and to evaluate contracts. Contact the ACCMA at 510-654-5383 for assistance.
2. Blue Cross Switches to Paperless EOBs; Doctors Can Still Opt to Receive Paper
Physician practices that have previously registered for Blue Cross's online provider portal, ProviderAccess, will no longer receive printed EOBs with their checks. Effective October 6, you will be required to go to Blue Cross website to obtain claims information and download or print out EOBs, which will only be available online for 18 months. Practices that have not registered for ProviderAccess will continue to receive paper EOBs. Thanks to CMA advocacy, physicians may now opt-out of the paperless EOB program by calling Anthem Network Relations at 800/933-6633.
3. Blue Cross to Change Claim Editing Software
Blue Cross is switching to a new claim editing software effective November 7. Because of this change, physicians may notice a difference in how certain codes and code pairs are adjudicated. Physicians will be able to prospectively and retrospectively screen claims via Blue Cross's "Clear Claim Connection" portal to determine if and how the claim auditing rules impact their claims.
News
- Medi-Cal Payments on Hold
- While most physicians continue to be paid for Medi-Cal claims, some Medi-Cal payments are being held up while the California Legislature negotiates a new State budget.
- PECOS Enrollment Update
- To ensure adequate time to process applications before the January 3, 2011. Medicare is strongly encouraging physicians who are not currently enrolled in PECOS to initiate Medicare enrollment.
- CalOSHA ATD Regulations
- Effective September 1, new CalOSHA standards will require employers in health care settings to take measures to protect employees from aerosol transmissible diseases.
- MBC Notice to Consumers
- California physicians are now required to provide a "Notice to Consumers" to notify patients that they are licensed and regulated by the Medical Board of California (MBC). Find resources to comply.