Volume 13, 2007

Issue 25 - What Healthcare Providers Need to Know about Medicare Private Fee-For-Service
BlueShield of Northeastern New York is pleased to announce that as of January 1, 2008, we will offer Traditional Blue Medicare Private-Fee-For-Service (PFFS) to Medicare eligible consumers.
Issue 24 - Part D Covered Vaccines and Administration
In 2008, CMS requires that vaccines and the administration fees associated with vaccines be covered under Part D, instead of Part B.
Issue 23 - Inhalation Medication Benefit Change for Medicare Advantage
The following bulletin contains important information regarding a benefit change for Medicare Advantage members.
Issue 22 - 2008 Fee Schedule Update
The following bulletin contains information regarding BlueShield's upcoming fee schedule changes, site-of-service payment differentials and an explanation of our reimbursement methodology.
Issue 21 - Plumbers & Steamfitters Local 7 Welfare Plan
BlueShield is pleased to announce that beginning December 3, 2007, claims submitted Plumbers & Steamfitters is a self-funded group with a product based on our PPO 898 plan. As a self-funded plan, the group is able to make certain decisions concerning the administration of its plan.
Issue 20 - NPI Updates
BlueShield is pleased to announce that beginning December 3, 2007, claims submitted with both an NPI and Legacy ID will be processed under the NPI.
Issue 19 - Duplicate Withdrawals Claims Adjustments
BlueShield recently contacted providers regarding claims processing system updates which took place the weekend of October 19.
Issue 18 - Rescheduled Checkwrites Due to System Upgrades
BlueShield of Northeastern New York will be performing maintenance and upgrades to its claims processing system beginning Friday, October 19 and continuing through Sunday, October 21.
Issue 17 - Rescheduled Checkwrites Due to System Upgrades
BlueShield of Northeastern New York will be performing maintenance and upgrades to its claims processing system beginning Friday, October 19 and continuing through Sunday, October 21.
Issue 16 - 2008 Senior Blue Benefit Change
The following information is an important benefit upgrade for Medicare Advantage (Senior Blue) members.
Issue 15 - 2007 - 2008 Flu Season Updates
This STAT Bulletin summarizes BlueShield of Northeastern New York's 2007 2008 Flu Vaccine reimbursements and policies.
Issue 14 - Reimbursement For Injectable Medications
As you know, the cost of pharmaceuticals is escalating at a rate that is far greater than the overall rate of inflation, and it is placing a significant burden on the nation’s healthcare system.
Issue 13 - NPI Contingency Plan
BlueShield has changed the date for accepting NPI only for electronic and paper claims. HealthNow will be able to accept NPI only as of December 3, 2007.
Issue 12 - New Fee Schedule for Orthotic and Prosthetic Codes 9-1-07
Based on numerous inquiries received from our provider community, BlueShield will be implementing a change in our reimbursement for HCPCS "L" codes.
Issue 11 - PaySpan Health
Last fall, BlueShield communicated that we would offer providers the opportunity to enroll with PaySpan Health, an access to vouchers. We are pleased to announce that PaySpan Health will be operational beginning July 17, 2007 www.payspanhealth.com.
Issue 09 - Board Certification Requirement
Effective July 1, 2007 BlueShield of Northeastern New York requires all new physician practitioners other than those who have completed their training within the previous five (5) years to be board certified in their specialty.
Issue 08 - Submit G-codes for All Lines of Business
In an effort to collect data for future quality measures, BlueShield of Northeastern New York is requesting physicians to submit the G-codes to our plan for all lines of business.
Issue 07 - Prefix Changes for Medicare and Medigap Products
BlueShield of Northeastern New York's current prefix for Medigap and Medicare Carve-Out lines of business is ZWL. In order to identify this portion of our business more clearly, we have assigned new prefixes to each of these products.
Timothy’s Law is effective for all employer groups — new and existing — that renew on or after January 1, 2007. The provisions of the law are applicable as each group renews its benefits during 2007.
Issue 05 - Continuous Passive Motion in the Home Setting
This bulletin contains important information regarding coverage of the Continuous Passive Motion exercise device.
Issue 04 - Important News Regarding Administration Codes 90471 and 90472
The changes to our system for reimbursement of vaccination delivery codes 90471 and 90472 are in production as of Friday, February 9, 2007.
Issue 03 - Important Host Claims Information
As a result of the merger of Anthem and WellPoint, Empire Blue Cross will not be able to host claims for members with the following Plan Codes:301 801
Issue 02 - Claims Overpayment Recovery Process Changes and Significant System Edits Publication Notice
This bulletin summarizes BlueShield of Northeastern New York's compliance activities related to Chapter 551 of the 2006 Laws of New York State ("Bradley Bill").
Issue 01 - Computerized Corneal Topography Coding Change
The following bulletin contains important information regarding billing guidelines for Corneal Topography.
Issue 10 - Preauthorization Reminder for Skilled Nursing Facilities and Acute Rehabilitation Admissions
The following contains steps and information when a BlueShield member has been referred to your facility for a SNF/Rehab admission.