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Providers

Alerts and Updates

Stay up-to-date on the latest. Updates serve as an amendment to your provider agreement and contractual relationship. Please file each issue below and keep it with your policies and procedures manual.

EFT & 835 ALERT:

It has been identified that some of the distribution of EFTs and 835s have been disrupted. There is no need to submit another EFT/ERA form. The EFT/ERA process will resume on or before the 7/2/2019 payment cycle. In the meantime, payments will be issued via paper checks as well as paper remits. We apologize for the inconvenience.

Happening Now

New resource provided. Learn how to read a remits paper adjustment using the new resource provided to you in our "Happening Now" section. 5/31/2019
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Provider Newsletter Updates

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Recent Updates

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.