Your card opens the door to a large network of top doctors to care for you. If you just found out that you need surgery, or if you will be admitted to a hospital or ambulatory surgical center for any reason, you will most likely receive some care during your stay from a hospital-based physician. An email address is required in the space below. Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health Service & Indemnity Company. This information is not a complete description of benefits. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Open Enrollment may be over, but you could still be eligible for coverage with a qualifying life event. External link You are leaving this website/app (site). Our quarterly newsletter features the latest news for network providers. | This new site may be offered by a vendor or an independent third party. Blue Cross and Blue Shield of Louisiana and its subsidiaries, HMO Louisiana, Inc. and Southern National Life Insurance Company, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. If there is a difference between any policy and the Members plan of benefits or Certificate of Coverage, the plan of benefits or Certificate of Coverage will govern. In addition, some sites may require you to agree to their terms of use and privacy policy. Blue Cross members of both individual and employer health plans will be able to get a U.S. Food and Drug Administration (FDA)-approved COVID-19 vaccine for $0 out of pocket. Type at least three letters and we will start finding suggestions for you. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. We keep you covered with more than 12,000 doctors in our network. All rights reserved. Select a Region: Please Select One DVEST1 DV9ST1 DV8ST1 DV5ST1 DV4ST1 DV1ST1 DVPST1 DVOST1 DVMST1 DVJST1 DVHST1 DVGST1 DVFST1 DVEST1 DVDST1 DVCST1 LOEST1 October 2022 Procedure Code and Fee Schedule Updates . Log in to your online account to view and download a digital version of your Blue Cross member identification card. A Fee-For-Service Plan (FEP Blue Standard and FEP Blue Basic Options) with a Preferred Provider Organization . We can help you find the right coverage for your needs. To access this area, please obtain the password from your Network Management Office. Blue Advantage from Blue Cross and Blue Shield of Louisiana is a PPO plan with a Medicare contract. If you're looking for a straight answer to your healthcare questions, this is the place. Applicable modifiers on claims for behavioral health services . | Learn more about what's covered and what's available to you on your new health plan. You will first see the physician network agreement information, then the . Portugus | App Store is a service mark of Apple Inc. Google Play is a trademark of Google Inc. Access the BCBSTX participating physician and professional provider Fee Schedule Request Form by selecting the county where services are provided from the Area/County List below. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Complete the form and select Submit to receive the appropriate professional fee schedule (s). You may also see our Summary of Benefits for more information. Understand your plan, learn about health savings accounts, and watch helpful videos. Blue Cross and Blue Shield of North Carolina provides fee schedule information to participating physicians electronically. Our fee updates reflect generally applicable market changes, such as CMS code changes, pricing for newly available drugs, fluctuations in prices for listed drugs, other market shifts, correction of over- or undervalued fees, and modifications based on ongoing utilization analysis. Find information and requirements for managing services to members. Medical Policies and Clinical UM Guidelines, Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Explanation Of Payment (EOP) Policy Crosswalk. Find a Plan Get Free Kit Turning 65 or new to Medicare? One option is Adobe Reader which has a built-in reader. Access electronic services including iLinkBlue, online authorizations and more. The actual impact to any particular provider will depend on the codes most frequently billed by that provider. With Blue Advantage (HMO) | Blue Advantage (PPO), you get Medicare coverage, plus so much more. Please complete the information below to request a fee schedule. One option is Adobe Reader which has a built-in reader. Need help? R13368-B_Provider Enrollment Form Rev 10/1/21 . | Set up and manage your electronic payments from Blue Cross. Keep more money in your pocket every month. As referenced in our February newsletter, this years annual review was delayed because of the CMS fee schedule modifications made in late December in response to the Consolidated Appropriations Act, 2021. Federal Employees: 1-800-492-8872 You also get extra benefits at no additional cost. The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers. Find out more about this imaging assessment shopper program. In Maine: Anthem Health Plans of Maine, Inc. Find out which plan is right for you. The site may also contain non-Medicare related information. Keeping your mouth healthy is key to your overall health. Fee Schedule Request Form . 4231. CPT copyright 2021 American Medical Association (AMA). Espaol | Blue Cross and Blue Shield of Louisiana/HMO Louisiana, Inc.130 DeSiard Street, Ste. Professional providers participating in our Preferred Provider Option (PPO), Blue High Performance NetworkSM (BlueHPNSM) and Blue Choice PPOSM networks may use the Fee Schedule Listing tool on Availity Essentials to submit electronic requests and receive the contracted price allowance for specific codes. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Electronically submit and manage requests for services and procedures. Blue Cross and Blue Shield of Louisiana, an independent licensee of the Blue Cross Blue Shield Association, offers Blue Advantage (PPO). Urgent care Can members schedule appointments: . The conversion factor for certain codes may vary by place of service. 02/02/2020 FEP will waive . | The 34 independent BCBS companies insure more than 107 million members across all 50 states, the District of Columbia, and Puerto Rico. The billed code(s) should be fully supported in the medical record and/or office notes. Want to learn more about how to use this tool. Date . Blue Advantage from Blue Cross and Blue Shield of Louisiana HMO is an HMO plan with a Medicare contract. . This change is applicable to providers who are reimbursed, either in whole or in part, based on the fee schedule for laboratory services for Medicaid. Professional Provider Office Manual. Look for the "Fee Schedule" link under Payment & Refund in the main menu. Blue Cross and Blue Shield Service Benefit Plan www.fepblue.org 2021 . One option is Adobe Reader which has a built-in reader. State & Federal / Medicaid. In Kentucky: Anthem Health Plans of Kentucky, Inc. Choose a state to see how Blue Cross Blue Shield is working in your community. We have partnered with Lucet for their expertise in the provision of mental health services. Learn more. Our fee schedule is being updated to better align with the market and standards set by Centers for Medicare & Medicaid Services (CMS). If you have questions about this communication or need assistance with any other item, contact your local Provider Relations representative or call Provider Services at 1-855-661-2028. Visit Blue365. Copyright document.write(new Date().getFullYear()) Health Care Service Corporation. We work with doctors, hospitals and clinics around Louisiana to make sure you have a better healthcare experience. For portal assistance call (800) 716-2299 option 3 or email EDIServices@bcbsla.com. Choose new challenge questions and answers when prompted. Providers and facilities are required to use industry standard codes for claim submissions. Blue Cross and Blue Shield of Texas (BCBSTX) is implementing changes in the maximum allowable fee schedule for Blue Choice PPOSM, Blue EssentialsSM (including HealthSelectSM of Texas Network), Blue PremierSM, Blue Advantage HMOSM, MyBlue HealthSM and PAR Plan networks (collectively referred to as "Networks") effective March 1, 2020. Ting Vit | Search for meal delivery, transportation, job training and other services near you. This information does not apply to members who have Medicaid or Medicare plans. Now is the time to find the right Medicare plan that fits your changing healthcare needs. External links open in new windows to websites Blue Cross and Blue Shield of Louisiana does not control. Milliman Care Guidelines (MCG) and the CMS Provider Reimbursement Manual. Health Equity and Social Determinants of Health (SDoH), Over the Counter Equivalent Exclusion Program, Prior Authorization and Step Therapy Programs, Consolidated Appropriations Act & Transparency in Coverage, Medical Policy/Pre-certification: Out-of-area Members, Anesthesia Clinical Payment and Coding Information, Coordinated Home Care/Private Duty Nursing, Drug Testing Clinical Payment and Coding Policy, Evaluation and Management (E/M) Services Coding Facility Services, Evaluation and Management (E/M) Coding Professional Provider Services, Increased Procedural Services (Modifier 22), Intraoperative Neurophysiology Monitoring Coding and Reimbursement Guideline, Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy, Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU), Observation Services Tool for Applying MCG Care Guidelines Clinical Payment and Coding Policy, Outpatient Facility and Hospital Claims: Revenue Codes Requiring CPT or HCPCS Codes, Paravertebral Facet Injection Procedure Coding & Billing Policy, Point-of-Care Ultrasound Examination Guideline, Psychological and Neuropsychological Testing, Therapeutic, Prophylactic and Diagnostic Injection and Infusion Coding, Unlisted/Not Otherwise Classified (NOC) Coding, Wasted/Discarded Drugs and Biologicals Guideline. Click below to search for Hospitals or Medical Providers in the Vantage Network. Participating physicians with access to Blue e have the ability to view their fee schedule. This new site may be offered by a vendor or an independent third party. In every state and every community, BCBS companies are making a difference not just for our members, but For the Health of America. Deutsch | Local Provider Directory Evaluation & Management services To view the NDC Reimbursement Schedule, registerorlog into Blue Access for Providers. Certain policies may not be applicable to Self-Funded Members and certain insured products. Save this page to your browser favorites to easily access iLinkBlue going forward. For your convenience, we have formatted the fee updates spreadsheets to include a sort filter on each column and an added column displaying the percentage of change in the total fee. Blue Cross and Blue Shield of Louisiana HMO offers Blue Advantage (HMO). Please select the option that best fits your plan type. Blue Cross and Blue Shield of Louisiana, an independent licensee of the Blue Cross Blue Shield Association, offers Blue Advantage (PPO). Blue Cross and Blue Shield of Louisiana HMO offers Blue Advantage (HMO). To access the updates, log in to azblue.com/providers and go to Provider Resources > Guidelines > Claim Pricing. Select one of the Fee Updates links: ASC, Outpatient, Professional, Unclassified Drug, or Per Diem Base Rates. Clinical payment and coding policies are based on criteria developed by specialized professional societies, national guidelines (e.g. Ting Vit | Aetna Waived 4-Jun Teladoc options through the Aetna Health app; Network providers who deliver virtual care, such as live video - conferencing; and other virtual As always, our yearly update, effective May 1 this year, is considerably larger in scope than our quarterly updates and affects a substantial number of codes. To access your member services, please visit your BCBS company. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Blue Cross and Blue Shield of Louisiana is licensed to sell products only in the state of Louisiana. 2023 Blue Cross Blue Shield Association. Patient Protection and Affordable Care Act Preventive Care Services Billing Guideline Use this billing guideline for information on certain preventive care services that are available without a cost to members. Availity provides administrative services to BCBSIL. Member Discounts Take advantage of member-only discounts on health-related products and services. Availity provides administrative services to BCBSIL. Interested parties may contact the Records Division on (269) 385-6191 to verify if the report of interest is available. We can help you get coverage. The downloadable form is available on the Forms page on our Provider website. Blue Cross and Blue Shield of Louisiana and its subsidiary, HMO Louisiana, Inc., comply with applicable federal civil rights laws and do not exclude people or treat them differently on the basis of race, color, national origin, age, disability or sex. Join the conversation and stay connected with us for exclusive content. Each organization must pick a representative to manage access to our secure online services. Copyright 2022 Blue Cross and Blue Shield of Louisiana. Licensees of the Blue Cross and Blue Shield Association. To access the interactive fee schedule tool, click the " Fee Schedule " link under Payment & Refund in the ProviderAccess main menu. Only users with an active user ID and password who currently use Blue Access for Providers to view the National Drug Code Reimbursement Schedule should take these steps between May 2 and June 30, 2022, to maintain your existing password: If you dont take these steps, youll need to reset your password after June 30. Who does this apply to? You can preview the updates on the secure provider portal starting April 1, 2021. These include Medicare fee schedules, information derived from claims, competitive pricing data, and feedback from BCBSAZ network providers. Alaska Fee Schedule | Provider | Premera Blue Cross Blue Shield of Alaska Alaska Fee Schedule March 4, 2021 We're updating the Premera Blue Cross Blue Shield of Alaska plan fee schedule for professional services effective for dates of service beginning May 15, 2021. Thinking about your Medicare options? BCBS recognizes doctors and hospitals for their expertise and exceptional quality in delivering care. Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross and Blue Shield Association and incorporated as Louisiana Health Service & Indemnity Company. Blue Cross and Blue Shield of Texas, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). All Rights Reserved. With gym packages starting at $19 a month, you'll have access to 11,000 participating fitness locations around the state and nation. Y0132_23-205_MKLA - Last Updated 01/05/2023. The site may also contain non-Medicare related information. Services should be billed with CPT codes, HCPCS codes and/or revenue codes. We want to assist physicians, facilities and other providers in accurate claims submissions and to outline the basis for reimbursement if the service is covered by a members benefit plan. Plan documents include, but are not limited to, Certificates of Health Care Benefits, benefit booklets, Summary Plan Descriptions, and other coverage documents. Anthem Blue Cross and Blue Shield (Anthem) recently notified members of the upcoming changes to its Anthem Plan Fee Schedules, scheduled to take place July 1. 322Monroe, LA71201, Toll Free:1-800-232-4967(TTY 711)Fax:1-877-553-6152, Telephone lines are open 8 a.m. to 8 p.m., 7 days a week. Pilipino | Reference Section - Updated 1/1/2023. All Rights Reserved. Please note that files will be pulled. To review BCBSIL's Schedule of Maximum Allowances for PPO and Blue Choice PPO providers, you must submit a Fee Schedule Request Form to BCBSIL via fax, along with a signed Confidentiality Agreement. Blue Advantage from Blue Cross and Blue Shield of Louisiana HMO is an HMO plan with a Medicare contract. Refer to the Member's plan of benefits or Certificate of Coverage to determine whether coverage is provided or if there are any exclusions or benefit limitations applicable to any of these policies. A drug list* is a list of prescription drugs your health plan covers. Blue Cross and Blue Shield Professional Fee Schedule Request To request a copy of your Blue Cross and Blue Shield of Minnesota professional fee schedule, please complete this form and submit via email to: Fee_Schedule_Allowance_Request@bluecrossmn.com BCBSIL makes no endorsement, representations or warranties regarding any products or services provided by third party vendors and the products and services they offer. Member Discounts Take advantage of member-only discounts on health-related products and services. Coding resources Coding types and sources Coding This program makes cost and quality information more transparent. Starting June 10, 2020, Blue Cross Dental Blue members can get free access to the Toothpic app for 3 months. If you want to see if the prescription drugs you're taking are covered by your plan, use the drug lists below. Children diagnosed as obese may be eligible for benefits from Blue Cross. With Blue Advantage (HMO) | Blue Advantage (PPO), you get Medicare coverage, plus so much more. Independent licensees of the Blue Cross and Blue Shield Association. We require credentialing for both professional and facility providers. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Significant changes to the physician fee schedules are included in the Blue Review provider newsletter. Providers' News / March 2020 Physician fee schedule adjustment delayed, due to COVID-19 Statewide net increase for inpatient hospital, outpatient hospital and ambulatory surgery center services moves ahead Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. We offer a complete choice of plans to meet your coverage needs and fit your budget. Blue Cross wants to help your patients live healthy lives. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Effective January 1, 2021, Anthem Blue Cross and Blue Shield Medicaid (Anthem) will update the Reference Laboratory Fee Schedule for Anthem. There may be times when these policies are superseded by state, federal or CMS requirements. | External link You are leaving this website/app (site). Contracted providers may obtain the NDC Reimbursement Schedule through Blue Access for ProvidersSM. Our new SmartShopper tool lets members compare common medical procedures based on price and location. We offer a series of disease and case management programs. If you don't receive a notification from us, our dental fee schedule hasn't changed. Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. As always, please check member benefits and eligibility. Deutsche | Where you go and who you see for treatment is a big part of getting quality healthcare while saving money. As in the past, BCBSRI uses the Rhode Island Medicare Fee Schedule (RIMFS) and its resource-based relative value scale (RBRVS) pricing methodology, as the basis for development of our fee schedule. On Jan. 1, 2023, BCBSIL will implement Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS) procedure code additions, deletions and revisions. Picking a primary care doctor is an important step to staying healthy and saving money. You also get extra benefits at no additional cost. Find out how Blue Advantage helps keep you safe during the COVID-19 pandemic. CPT is a registered trademark of the AMA. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. The Outpatient Facility Fee Schedule applies to Blue Shield of California Facility Outpatient Surgery, Outpatient Radiology, Outpatient Clinical Laboratory, and Outpatient Pharmaceuticals. | In addition, some sites may require you to agree to their terms of use and privacy policy. | The State Health Plan dental and health fee schedules are available to download in Excel file formats. Were making Blue Access for Providersmore secure. Access manuals, speed guides, tidbits, presentations, tutorials and forms. Please note that as a Blue Advantage member, you must continue to pay your Medicare Part B premium. Blue Cross and Blue Shield of Louisiana Enters Into Definitive Agreement to be Acquired by Elevance Health, Deal will result in $3 billion foundation focused on improving Louisiana. See your choice of network doctors and specialists without a referral. | Providers | Blue Cross and Blue Shield of Louisiana | Home Network Enrollment Learn more about our network requirements and credentialing program.

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