Alerts and Updates
Stay up-to-date on the latest. Updates serve as an amendment to your provider agreement and contractual relationship. Please download and file each issue below and check the provider procedures regularly.
Happening Now
Stay up-to-date with important news and information specific to our provider community.
Commercial and FEP Updates » Medicare Advantage Updates »
Recent Updates
- MPC May 2025 (posted 05/06/2025)
- Genetic Testing Update (Posted 3/31/2025)
- Provider Notification March 2025 (posted 03/14/2025)
- Genetic Testing Update (Posted 10/02/2024)
- MPC August 2024 (posted 08/21/2024)
- MPC May 2024 (posted 05/28/2024)
- MPC February 2024 (Posted 02/29/2024)
- Genetic Testing Update (Posted 03/28/2024)
- MPC November 2023 (Posted 12/01/2023)
- Readmission Policy and Genetic Testing Updates (Posted 9/29/2023)
- MPC August 2023 (Posted 08/31/2023)
- MPC May2023 (Posted 05/26/2023)
- MPC April 2023 (Posted 04/27/2023)
- MPC February 2023 (Posted 02/24/2023)
- Medicare Advantage Part B Drug Updates Effective 07/01/2025
- Medicare Advantage Medical Policy Updates (07/01/2025)
- MA Prior Authorization and Precertification Requirements
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- Ablation of Peripheral Nerves to Treat Pain
- Ambulatory Event Monitors and Mobile Cardiac Outpatient Telemetry
- Bioengineered Skin and Soft Tissue Substitutes
- Computer-Assisted Musculoskeletal Surgical Navigation Orthopedic Procedure
- Cosmetic and Reconstructive Surgery
- Drug Eluting Sinus Stents
- Implantable Bone Conduction and Bone-Anchored Hearing Aid
- M.7 MA Gender Reassignment Surgery, effective 01/01/2025
- M.19 MA MRT, effective 01/01/2025
- MA Accelerated Irradiation Therapy, Brachytherapy, effective 01/01/2025
- MA Charged Particle Radiation, effective 01/01/2025
- MA Radioembolization Selective Internal Radiotherapy, effective 01/01/2025
- Multimarker Testing Related to Ovarian Cancer
- Myoelectric Upper Limb Prosthesis
- Percutaneous Disc Procedures
Steps to print a webpage as a PDF on Windows 11:
- Open the Webpage you want to print as a PDF.
- Access the Print Menu:
- Press Ctrl + P on your keyboard, or go to the menu and select File > Print.
- Select the Printer:
- In the print dialog box, select Microsoft Print to PDF from the list of available printers.
- Adjust Print Settings:
- Configure any print settings you need, such as page range, orientation, and number of copies.
- Print:
- Click the Print button.
- Save the PDF:
- A dialog box will appear asking you to choose a location to save the PDF file. Enter a file name, choose the location, and click Save.
And that’s it! Your document or webpage will be saved as a PDF in the location you specified.
Steps to print a webpage as a PDF on a Mac:
- Open the Webpage you want to print as a PDF.
- Access the Print Menu:
- Press Command + P on your keyboard, or go to the menu and select File > Print.
- Select Save as PDF:
- In the print dialog box, look for a PDF button at the bottom-left corner. Click on it and select Save as PDF from the dropdown menu.
- Save the PDF:
- A dialog box will appear asking you to choose a location to save the PDF file. Enter a file name, choose the location, and click Save.
And that’s it! Your document or webpage will be saved as a PDF in the location you specified.
May 2025 Update
Exciting partnership with Cotiviti for enhanced payment accuracy, Reminder: Updated TriWest information for BCBSNE providers, The importance of kidney and eye health in diabetic patients, Ensuring accuracy: Blue Cross and Blue Shield of Nebraska's upcoming Risk Adjustment Data Validation audit and more.
March 2025 Update
Qualified Medicare Beneficiary (QMB) program, Updated TriWest information for BCBSNE providers, Exciting updates for our provider community: Preauthorization changes, Join us at the 2025 NDA Annual Session, Diabetes: Documentation essentials for providers and more.
January 2025 Update
Reminder: Updating NPPES data registry, HEDIS® Medical Record Reviews, BCBSNE provider networks are unique and specific to the member’s plan, Cardiovascular Disease: Documentation essentials for providers and more.
January 2025 Medicare Advantage Update
New ID number for current BCBSNE Medicare Advantage members effective Jan. 1, 2025, MA Provider Procedure updates, MA provider customer service for 2025, Medicare Advantage Split-Year Claim Submission and more.
November 2024 Update
Q4 reminder to verify provider directory information in CAQH by end of year, Reminder: Emailing provider executives, New ID number for current BCBSNE MA members effective Jan. 1, 2025, MA split-year claim submission, Medicare Advantage Access Standards and more.
September 2024 Update
BCBSNE Provider Procedures Name Update, Diagnostic related group (DRG) audits impacted by Change Healthcare event, NaviNet®: Available to dentists, BCBSNE MA Auto Approval for SNF Admissions, Medicare Advantage Provider Procedure Updates and more.
July 2024 Update
BCBSNE’s Medicare Advantage plan is moving in-house for 2025. Recent updates to policies. G0109 (Group Diabetic Education) was added to our telehealth policy effective July 1, 2024, Submitting Corrected Dental Claims, Medicare Advantage Access Standards, Best Practices for Medication Adherence and more.
May 2024 Update
Recent updates to policies, G0109 (Group Diabetic Education) will be added to our telehealth policy effective July 1, 2024, Monaural hearing aids, Orthodontic claims for University of Nebraska members, Medicare Advantage Access Standards and more.
March 2024 Update
Reminder: Claim Return letters are going paperless on April 1, 2024, Reminder: Self-Serve with new claim denial information available in NaviNet®, Recent updates to Medical Policy, Reminder: Submitting corrected claims, Submitting corrected claims and more.
Jan. 2024 Update
Provider Directory: Make Sure Your Information is Correct, Streamlining the Process for Provider Directory Updates, Reminder - Medical Records Standards, University of Nebraska joining BCBSNE in 2024 and more.
Nov. 2023 Update
State Mandate for Telehealth Reimbursements, Changes to our Readmission Policy and Genetic Testing policy, Pegfilgrastim preferred biosimilar medication requirements, Hyaluronic acid preferred medication requirements and more.
Sept. 2023 Update
Remember to discuss fall risk, urinary incontinence and physical activity with Medicare patients, Blood pressure coding can reduce HEDIS® medical record requests, remind your eligible patients to get regular mammograms and more.
July 2023 Update
ID Card Updates, The Gold Card Program, Coordination of Benefits (COB) Timely Filing updates and more.
May 2023 Update
COVID-19 national emergency and public health emergency ending, NaviNet® Enhancements, Risk Adjustment Data Validation Audit, Mental Health Providers and Telehealth, Remicade changes and more.
March 2023 Update
No Surprises Act and Qualifying Payment Amount (QPA), Mental Health Providers and Telehealth Updates, Medicare Advantage Updates, Provider Directory Reminders and more
January 2023 Update
Annual Provider Survey updates, Medicare Advantage updates, NaviNet updates and more
November 2022 Update
Provider Directory: Make Sure that your information is correct, participating requirements, NaviNet: New enhancements are live, CLIA tests and QW modifier and more
September 2022 Update
Mandated changes coming to provider directory updates, coming this fall: new policies and procedures tool, Nebraska HeartlandBlue, NaviNet changes coming soon and more
July 2022 Update
COVID-19 Policies, Medical Policy Updates, Multiple Procedure Adjustments for Payment, Modifier 52, Professional Fee Schedule and more
May 2022 Update
New Features, COVID-19 Policies, New patient visits, Colorectal cancer screening changes, Educators Health Alliance member updates, Navinet and more
March 2022 Update
Telehealth and new place of service code effective April 1, 2022, Medical policy updates are now online, New self-service features coming soon to NaviNet and more
December 2021 Update
New on NebraskaBlue.com: More resources on coding, billing, claims and more, Amazon Pharmacy and MedsYourWay™, a new home delivery option, New diabetes solutions coming for 2022 and more
November 2021 Update
New ID cards with QR Codes, skin tag removal, Step therapy and more
September 2021 Update
Change to accreditation requirements, encourage vaccination for your pregnant patients, new out-of-network facility in Papillion, HEDIS® results for measurement year 2020 and more.
July 2021 Update
Ambulance de-credentialing, expanded requirements for genetic and molecular testing, new benefit changes for multiple sclerosis medications, documenting and coding for depression, billing for sepsis
and more.
May 2021 Update
Pharmacy update, ASC claims billing, credentialing for Licensed Medical Nutrition Therapists (LMNT), peer-to-peer calls, coding for diagnostic radiology and lab tests and more.
March 2021 Update
Save feature added to preauthorization tool, peer-to-peer reminders, medical record review, weight-related diagnosis coding and documentation, changes to oncology medication reimbursement tiers and more.
January 2021 Update
Out-of-state members and preauthorization, risk adjustment data validation audit (RADV), HEDIS medical record reviews starting, multiple surgery claims, timely filing and medically unlikely edit (MUE) denials, and intraocular lens implants.
December 2020 Update
Training for enhanced preauthorizations, facility accreditation, correcting professional claims, returned claims and more.
November 2020 Update
Happening now, COVID-19 updates, timely filing, evaluation and management codes, billing, clinical, credentialing, pharmacy and risk adjustment and risk management updates.
September 2020 Update
Coronavirus (COVID-19) updates, Happening Now, telehealth provider characteristics, Documenting Pediatric Hierarchical Condition Categories and reminders.
July 2020 Update
Coronavirus (COVID-19) updates, Happening Now, enhancements to online preauthorizations coming fall 2020, site-specific modifies and NaviNet Insider.
May 2020 Update
Coronavirus (COVID-19) updates, taxonomy required on all claims, medical claim status questions, modifier 25, immediate family members, medicare advantage prior authorization update, ASC billing invoices, bilateral procedure billing and more.
March 2020 Update
Coronavirus (COVID-19) updates, telehealth, Federal Employee Program (FEP), bilateral procedure billing, therapy policy updated, new name for centers of excellence program, NaviNet tips, 2020 HEDIS Medical Record Review and more.
January 2020 Update
Medicare Crossover Claims, Provider Characteristics-Opioid Medication Assistance, Provider Characteristic Codes, Provider Tools, NaviNet, MedPolicy Blue, Inquire About Claims Online or By Phone and more.
December 2019 Update
HealthRules, CareFirst, Virta and Type 2 Diabetes Pilot Program, Medicare Advantage Expansion, HEDIS Medical Record Reviews Begin in February 2020, FEP Hospice Benefits, FEP 2020 Blue Distinction Benefit and more.
November 2019 Update
Armor Health, Therapy Payment Policy, Opioid Epidemic and Drug Abuse: Member Lock-in Program, Patient-Driven Payment Model and more.
September 2019 Update
Site of care for medical infusions policy, carpal tunnel payment policy, Happening Now and more.
July 2019 Update
New out-of-network facility in Millard, Emergency Department Utilization, reminders and more.
May 2019 Update
A special announcement to providers, Provider Service Improvements, NICU Levels of Care No cost to adjust/reconsider claims, Taxonomy code requirement and more.
March 2019 Update
Updated Reconsideration Request and Appeal Request Forms, Chiropractors and Physical Therapy - Maintenance Therapy (Amended), and more.
January 2019 Update
Claim Return Letters, Seven-day limit for opioid drugs, Peer-to-peer phone calls, Mark your calendar, Collaborative support for patients with diabetes, and more.
November 2018 Update
Hyaluronic acid injections products, high dollar review, mental health coverage, school place of service, BlueCard Bulletin, BCBSNE and FEP transition to new platforms, health fairs, FEP Blue Focus and more.
September 2018 Update
Sildenafil, reimbursement policies, colorectal cancer screenings, Fall provider conference, preauthorization requests, chiropractor and physical therapy, medicare record submissions and more.
July 2018 Update
Provider Executives, risk adjustment data validation, Bi-Partisan Budget Act, Preauthorization for Medicare Advantage and more.
May 2018 Update
Regional provider conference, pharmacy changes, policies and procedure updates, med policy blue, blueprint health, CMS mass adjustments, modifier -90 and more.
March 2018 Update
New CEO, walk at lunch, medical record retrieval, blue distinction for fertility care, RADV audit, late charges and replacement claims, change of address, appeal requests, mid-level reimbursement and more.
January 2018 Update
Alpha-numeric prefixes, testicular hypofunction, teleservices, FEP change, Gold Card Provider Program, mobile enhance maternity care program and more.
Steps to print a webpage as a PDF on Windows 11:
- Open the Webpage you want to print as a PDF.
- Access the Print Menu:
- Press Ctrl + P on your keyboard, or go to the menu and select File > Print.
- Select the Printer:
- In the print dialog box, select Microsoft Print to PDF from the list of available printers.
- Adjust Print Settings:
- Configure any print settings you need, such as page range, orientation, and number of copies.
- Print:
- Click the Print button.
- Save the PDF:
- A dialog box will appear asking you to choose a location to save the PDF file. Enter a file name, choose the location, and click Save.
And that’s it! Your document or webpage will be saved as a PDF in the location you specified.
Steps to print a webpage as a PDF on a Mac:
- Open the Webpage you want to print as a PDF.
- Access the Print Menu:
- Press Command + P on your keyboard, or go to the menu and select File > Print.
- Select Save as PDF:
- In the print dialog box, look for a PDF button at the bottom-left corner. Click on it and select Save as PDF from the dropdown menu.
- Save the PDF:
- A dialog box will appear asking you to choose a location to save the PDF file. Enter a file name, choose the location, and click Save.
And that’s it! Your document or webpage will be saved as a PDF in the location you specified.
April 2025 Provider Bulletin
Our dedicated provider portal, NaviNet®, is the preferred method for contacting Blue Cross and Blue Shield of Nebraska, Nebraska's Compact Licenses: Enhancing provider mobility with BCBSNE, Attention needed: Denied MA claims with frequency limits, Coming Soon: New edits for Local and HOST MA claims, BCBSNE transitions to new telehealth vendor for its employees - Telescope Health and more.
March 2025 Provider Bulletin
Exciting updates to the NaviNet® registration process, Protecting patient information: The importance of photo ID verification, Medicare Advantage value-based incentive program presentation, Updated TriWest information for BCBSNE providers and more.
February 2025 Provider Bulletin
Exciting updates to the NaviNet® registration process, Great news about verifying coverage on NaviNet, Reminder: Medicare Advantage reimbursement, TriWest system delays impacting provider services and more.
January 2025 Provider Bulletin
Medicare Advantage member ID numbers for 2025, 2025 MA prescription benefits, Updating NPPES data registry, Contact change for joining the University NE System Network, BCBSNE ends timely filing exception on Oct. 24, 2024 and more.
December 2024 Provider Bulletin
Medicare Advantage Claims update, Timely Filing Requests transition to NaviNet®, Urgent radiology preauthorization request line retiring, Reminder: Split-year claim billing and more.
November 2024 Provider Bulletin
Holiday hours, Preauthorization/Precertification process improvements on NaviNet®, Guidelines to prevent delays in preauthorization requests, Notice regarding preauthorization request withdraws in NaviNet and more.
October 2024 Provider Bulletin
Top three claim return reasons, Peer-to-Peer changes effective Dec. 10, 2024, New claim appeal status in NaviNet, Reminder: Emailing provider executives and more.
September 2024 Provider Bulletin
BCBSNE Medicare Advantage Provider Learn a Latte in-person events, Top three claim return reasons, Revised Medical Policies, effective Sept. 1, 2024, BCBSNE Provider Procedures Name Update and more.
August 2024 Provider Bulletin
Top three claim return reasons, Prevention TaskForce App, TRICARE Network Participation and Contract Confirmation and more.
July 2024 Provider Bulletin
BCBSNE’s Medicare Advantage plan is moving in-house for 2025, Medicare Advantage Claims Update, Durable Medical Equipment Reimbursement Cap, EAPG Providers and more.
June 2024 Provider Bulletin
Top three claim return reasons, BCBSNE’s Medicare Advantage plan is moving in house for 2025, Reminder: Taxonomy code requirement, EAPG Providers and more.
May 2024 Provider Bulletin
Top three claim return reasons, Turn-around time on CAQH updates, Reminder: Taxonomy code requirement, Medicare Advantage (MA) claims and more.
April 2024 Provider Bulletin
Top three claim return reasons, EAPG Providers, Claim Return, Reconsideration and Appeal letters are going paperless, Quick Tips - Coding and Documentation for Controlling Blood Pressure (CBP) and more.
March 2024 Provider Bulletin
Top three claim return reasons, ProviderPortalAuthQuestions@NebraskaBlue.com is no longer supported, Effective Jan. 1, 2024, BCBSNE will not cover CPT 99459 and more.
March 21, 2024 Provider Bulletin
Financial support in light of Change Health Care cyberattack
Feb. 2024 Provider Bulletin
Reminder: Preauthorization submissions via MedPolicy Blue no longer available, Reminder: New Claim-Denial Information Available in NaviNet, Reminder: Refund offsetting process for in-network providers and more.
Jan. 2024 Provider Bulletin
MedPolicy Blue preauthorization submissions will no longer be available beginning Feb. 1, 2024, Top three claim return reasons, ID numbers for new members, New claim-denial information available in NaviNet and more.
Dec. 2023 Provider Bulletin
Top three claim return reasons, Appointment availability surveys starting January 2024, University of Nebraska joining BCBSNE in 2024 and more.
Nov. 2023 Provider Bulletin
Learn the facts about Medicare Advantage plans, Reconsideration vs Timely Filing, Contacting BCBSNE, Claims denied with code MP27 and more.
Oct. 2023 Provider Bulletin
Welcome to our first edition, NaviNet® self-service timeline of events, September’s #1 provider claim return reason and more.
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