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Blue Bulletin

BlueCross BlueShield of WNY strives to provide our network of provider practices and facilities with the most current health plan information in a quick and easily accessible manner.

  • Update to Drug Therapy Guidelines for Stelara and Rituximab

    February 20, 2020

    Updated drug therapy guidelines for Stelara and Rituximab will be posted by March 1, 2020 and effective on April 1, 2020.
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  • Medical Protocol Updates Available Online

    February 20, 2020

    We recently reviewed 50 medical protocols. Updates will be posted online on or before February 28, 2020 and will have an effective date of April 1, 2020, unless otherwise noted.
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  • Is Your Information Current?

    January 23, 2020

    Keeping your practice information updated is important so new patients can find you in 2020. Beginning January 2020, we are partnering with BetterDoctor to help us keep our network provider information current. Since BetterDoctor works with many payers in our region, this should make the process more streamlined for your practice.
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  • Utilization Management: Coverage and Denial Processes

    January 23, 2020

    Understanding coverage and denial decisions, and knowing the right steps to take after an authorization denial will help your patient get the right care at the right time. We want to provide further guidance on the appeal process after an authorization denial.
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  • Osteoporosis Management in Women: Measure Guidelines and Coding Tips

    January 23, 2020

    We know the Osteoporosis Management in Women Who Had a Fracture (OMW) HEDIS measure poses challenges, including coding, time frames and patient screening. Here are some tips on how to ensure proper coding of, and adherence to, the OMW measure.
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  • Making Sense of Preauthorization

    January 23, 2020

    Obtaining preauthorizations can sometimes feel daunting. This process helps us pay claims faster, and reduces the likelihood of unexpected costs or denied charges for your patients. Here are a few tips that may help.
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  • Viewing Medicaid Members Assigned to Your Office

    January 23, 2020

    BlueCross BlueShield partners with Amerigroup Partnership Plan to help administer and manage our Medicaid Managed Care and Child Health Plus programs. In some instances, BlueCross BlueShield Medicaid members may be automatically assigned to your practice as their primary care provider (PCP).
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  • Improving Patient Experience

    December 23, 2019

    Providing high quality care is essential. But there are some small changes that may help improve how your patients feel about their overall health care experience during a visit to your office.
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  • 2020 Updates: Products, Benefits, and Prior Authorization Requirements

    December 23, 2019

    We know any coverage and benefit changes can affect your office. We’ve summarized some of the more significant updates coming for your BlueCross BlueShield patients beginning on January 1, 2020.
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  • Medicare Drug Management Program Through Express Scripts

    December 23, 2019

    We are working with Express Scripts® to support the CMS-mandated Drug Management Program beginning in January, 2020. The program is designed to promote safe and appropriate use of opioid medication for Medicare patients.
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