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 Partners in Health UpdateSM

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View the latest news and information specific to the Independence-participating provider community below:
Required lead time when updating your provider information (Administrative) P, F, A
View up-to-date policy activity on our Medical Policy Portal  (Medical) P, F, A
Enhanced claim edits to support correct coding principles and important information about Medicare Advantage (Billing & Reimbursement) P, F, A
Independence drug program formulary updates (Pharmacy) P, F, A
2019 – 2020 Clinical Practice Guidelines Summary now available  (Quality Management) P
Eleven new drugs added to the Dosage and Frequency Program (Medical) P, F, A
Changes to opioid management for members under 18 years of age (Pharmacy) P
Updates to the Blood Glucose Meter Program for commercial members (Pharmacy) P
New! $0 Personal Choice 65SM Prime Rx PPO plan and Medigap plans (Products) P, F, A
Coverage for emergency ambulance response and treatment without transport  (Administrative) A
Medicare Outpatient Observation Notice submission guidelines (Administrative) F
BriovaRx Specialty Pharmacy and Infusion Services has become Optum Specialty Pharmacy and Optum Infusion Pharmacy (Pharmacy) P
Vaccinations recommended for adult Independence members (Medical) P, F, A
BlueCard Medicaid claims cannot be processed without complete information (BlueCard) P
Independence offers language assistance services to help members and their beneficiaries communicate (Quality Management) P, F, A
Avoid documentation cloning (Billing & Reimbursement) P, F, A
Becoming a credentialed professional provider (Administrative) P
Changes to precertification requirements for intravitreal VEGF products effective January 1, 2020 (Medical) P
Find BlueCard program information on our dedicated BlueCard page (BlueCard) P, F, A
Help us improve your experience with the Provider Services Call Center (Administrative) P, F, A
Health Coaching: Programs to enhance the coordination of care for Independence members with health concerns  (Health and Wellness) P
Improving lead testing and developmental screening among CHIP members (Health and Wellness) P
Member cost-share information through the NaviNet Open Eligibility and Benefits Inquiry transaction (NaviNet Open) P, F, A
View up-to-date policy activity on our Medical Policy Portal  (Medical) P, F, A
Annual notification regarding utilization review decisions  (Quality Management) P, F
Ensure proper routing of CFID audit questions (Administrative) P, F, A
Required lead time when updating your provider information (Administrative) P, F, A
Scheduling annual well-care visits (Medical) P

NaviNet® Open

To help you navigate our secure, online provider portal and various transactions, we have created a central location for a variety of NaviNet web portal (NaviNet Open) resources, including user guides, webinars, and a communications archive.

NaviNet Open

Opioid Awareness

We have created a repository of tools and resources to assist you in managing your patients who are prescribed opioid medications.

Opioid Awareness Resources

Utilization Management

Certain utilization review activities are delegated to different entities. Here you will find detailed information on our utilization management programs and common resources used among them.

Utilization Management

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Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.