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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.

  • Q4 2019 Updated Drug Therapy Guidelines and Medical Protocols Available Online

    December 23, 2019

    Our drug therapy guidelines and medical protocols were recently updated and will be available online. We provide information about what’s affected, when these will be available and when they go into effect.
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  • Billing Requirements for Elective C-sections and Induction of Labor

    November 26, 2019

    We are aligning with Medicaid’s billing requirements for elective obstetric deliveries.
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  • HEDIS 2020 – What’s New, What’s Changing

    November 21, 2019

    As the end of 2019 approaches, we want to update you about HEDIS measures for 2020. We’ll summarize what you need to know.
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  • Optimizing Care for Asthma Patients

    November 21, 2019

    As we head into another Western New York winter, cold air has the potential to induce symptoms for the 30,000 BlueCross BlueShield patients with asthma, and exacerbations continue to rise every year.
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  • Updated Drug Therapy Guideline and Medical Protocol

    November 21, 2019

    An updated drug therapy guideline for Taltz will be posted today, and changes have been made to one of our medical protocols.
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  • Add-on Codes to Require Use of Appropriate Base Procedure Code

    November 21, 2019

    Beginning on March 1, 2020, we will only reimburse for add-on codes attached to a designated primary service or appropriate base procedure code.
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  • Grants Awarded to WNY Organizations in Support of Community Health Outcomes

    November 21, 2019

    Last month, 12 Western New York organizations were awarded Blue Fund grants for 2019 to support health-based community initiatives. Here’s more about the deserving recipients.
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  • Fraud Awareness and Deficit Reduction Act (DRA)

    November 21, 2019

    Health care organizations subject to Section 6032 of the Federal Deficit Reduction Act of 2005 (DRA) are required to educate their providers and contractors about the False Claims Act as well as the organization’s policies and programs for detecting and preventing fraud, waste and abuse.
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  • Medical Record Documentation Requirements

    November 21, 2019

    Accurate, complete, and legible medical record documentation is essential for delivering high-quality patient care. To improve adherence and consistency of medical record documentation, we perform an annual medical record review audit based on New York State Department of Health (NYSDOH) and the Centers for Medicare & Medicaid Services (CMS) standards.
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  • Timely Information Exchange Between Primary Care and Specialists Improves Care Transitions

    November 21, 2019

    The 2019 medical record review for timeliness and quality of information exchange between selected primary care providers (PCPs) and specialists was recently completed. A sample of 194 PCP records was reviewed.
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