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Billing & Reimbursement

Health and Wellness

Quality Management

Billing & Reimbursement

The Billing & Reimbursement section is designated for information pertaining to claims, billing, and reimbursement information and changes. You and your office staff can stay up-to-date on topics including clean claims, proper coding for disbursements, remittances, and specific billing procedures.

The following user guides provide detailed information about Provider Explanation of Benefits (EOB)/Remittances:

Provider EOB/Remittance

How to read your professional Provider EOB

How to read your facility Provider Remittance

Communications

Bill
2023 Updates
- •
  Professional Injectable and Vaccine Fee Schedule is updated Posted: 6/30/2023
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  Advanced Practice Provider credentialing and reimbursement Posted: 6/13/2023
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  New Medicare Advantage telehealth reimbursement rate effective June 1, 2023 Posted: 5/23/2023
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  Enhanced Claim Editor Program: Secondary diagnosis codes Posted: 5/8/2023
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  Enhanced Claim Editor Program: Obsolete NDC codes Posted: 5/4/2023
- •
  Action to come: Independence to transition to new EDI Gateway vendor Posted: 4/3/2023
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  Medicare Advantage telehealth reimbursement rate update Posted: 3/31/2023
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  Professional Injectable and Vaccine Fee Schedule Posted: 3/31/2023
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  Professional Injectable and Vaccine Fee Schedule updates effective January 1, 2023 Posted: 2/22/2023
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  Follow HIPAA guidelines to ensure successful claims processing Posted: 1/26/2023
Bill
2022 Updates
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  Provider Compliance with Part 2 Programs Posted: 12/22/2022
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  Billing and cost-sharing for individuals enrolled in the Qualified Medicare Beneficiary program Posted: 12/12/2022
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  Medicare Advantage telehealth reimbursement rate update Posted: 12/1/2022
- •
  Introducing Equian, a new vendor for facility audits Posted: 11/3/2022
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  Changes to claim payment policy on care management and care planning services Posted: 10/7/2022
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  Professional Injectable and Vaccine Fee Schedule updates effective October 1, 2022 Posted: 10/3/2022
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  Change to claim submission procedure for cataract reimbursement Posted: 8/22/2022
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  COVID-19: Suspension of timely filing requirements extended Posted: 8/17/2022
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  Reminder: CRNP and PA credentialing and reimbursement Posted: 8/16/2022
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  Professional Injectable and Vaccine Fee Schedule updates effective July 1, 2022 Posted: 7/22/2022
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  Enhanced Claim Editor Program Posted: 6/22/2022
- •
  Claim investigation and corrected claim submission procedures Posted: 6/6/2022
- •
  Enhanced Claim Editor Program: Modifier requirements Posted: 5/24/2022
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  Enhanced Claim Editor Program: Drug administration codes Posted: 1/19/2022
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  Enhanced Claim Editor Program – Identifying Automated Edits versus Coding Validator Reviews and choosing the correct dispute process Posted: 1/19/2022
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  Payer ID grids now available for 2022 Posted: 1/12/2022
Bill
2021 Updates
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  Billing and cost-sharing for individuals enrolled in the Qualified Medicare Beneficiary program Posted: 12/8/2021
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  Annual Wellness Visits via telehealth incentive to end Posted: 12/2/2021
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  Professional Fee Schedule updates – effective March 1, 2022 Posted: 12/1/2021
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  COVID-19 (Coronavirus): CRNP and PA direct supervision requirements Posted: 10/29/2021
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  CRNP and PA credentialing and reimbursement Posted: 10/7/2021
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  COVID-19 (Coronavirus): Member cost-share claims processing for PCP, specialist, and behavioral health telemedicine services Posted: 10/1/2021
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  Now in effect: MPPR on certain diagnostic services for outpatient facility providers Posted: 9/3/2021
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  REMINDER: Enhanced Claim Editor Program - Identifying Automated Edits versus Coding Validator Reviews and choosing the correct dispute process Posted: 7/15/2021
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  New Implant Reimbursement Request Form Posted: 7/6/2021
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  Professional Injectable and Vaccine Fee Schedule updates effective July 1, 2021Posted: 6/15/2021
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  Multiple procedure payment reductions on certain diagnostic services for outpatient facility providers Posted: 6/1/2021
- •
  CRNP contracting, credentialing, and collaborative agreements Posted: 5/20/2021
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  Enhanced Claim Editor Program: Reporting of nail trimming, nail debridement, and lesion trimming Posted: 4/6/2021
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  Enhanced Claim Editor Program: Upcoming areas of focusPosted: 3/25/2021
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  Enhanced Claim Editor Program: Identifying Automated Edits versus Coding Validator reviews and choosing the correct dispute process Posted: 3/2/2021
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  Enhanced Claim Editor Program: Coding Validator review and the reporting of manual therapy and CMT Posted: 2/22/2021
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  Enhanced claim edits to support correct coding principles – new coding validation program now in effect Posted: 2/4/2021
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  Updated payer ID grids now available Posted: 1/4/2021
Bill
2020 Updates
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  Submitting Blue High Performance Network^SM claimsPosted: 12/22/2020
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  BCBSA high-dollar prepayment claims review policy update Posted: 12/17/2020
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  Billing guidelines for leuprolide acetate (Fensolvi^®)Posted: 12/8/2020
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  Professional Injectable and Vaccine Fee Schedule updates effective January 1, 2021Posted: 12/1/2020
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  New policy for the reimbursement of administrative services for drugs, substances, and/or biologic agentsPosted: 11/16/2020
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  Reduce risk adjustment and Stars Program care gaps for out-of-area group Medicare Advantage PPO members Posted: 11/5/2020
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  Enhanced claim edits to support correct coding principles – New coding validation programPosted: 11/2/2020
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  Independence to decrease clinical update frequency for Medicare Advantage inpatient staysPosted: 10/14/2020
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  COVID-19 (Coronavirus): Temporary claims processing code J3490 added to allow payment for primary care telemedicine visits Posted: 10/5/2020
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  New revenue code for billing hospital servicesPosted: 9/30/2020
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  Professional Injectable and Vaccine Fee Schedule updates effective October 1, 2020Posted: 9/1/2020
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  Important information for professional providers Posted: 9/1/2020
- •
  Important reminder! CRNP contracting and credentialingPosted: 8/20/2020
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  Upcoming changes to EDI electronic claims processingPosted: 8/12/2020
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  Reminder: Enhanced claim edits to support correct coding principles and important information about ICD-10-CM Excludes NotesPosted: 7/24/2020
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  Billing and cost-sharing for individuals enrolled in the Qualified Medicare Beneficiary programPosted: 6/5/2020
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  Professional Injectable and Vaccine Fee Schedule updates effective July 1, 2020Posted: 6/1/2020
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  Medicare Advantage incentives for telehealth annual wellness visits during COVID-19 crisisPosted: 5/7/2020
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  Enhanced claim edits to support correct coding principles and important information about ICD-10-CM Excludes NotesPosted: 4/3/2020
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  Professional Injectable and Vaccine Fee Schedule updates effective April 1, 2020Posted: 2/24/2020
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  Clinical documentation improvements and general coding tips for Medicare Advantage membersPosted: 1/14/2020
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  Enhanced claim edits to support correct coding principles and important information about professional reporting of observation carePosted: 1/8/2020
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  Updated payer ID grids now available Posted: 1/8/2020
Bill
2019 Updates
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  Claim investigation and corrected claim submission proceduresPosted: 12/16/2019
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  Professional Injectable and Vaccine Fee Schedule updates effective January 1, 2020Posted: 12/2/2019
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  BCBSA high-dollar prepayment claims review policy updatePosted: 12/2/2019
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  Focus on reducing risk adjustment and Stars care gaps for out-of-area group Medicare Advantage PPO membersPosted: 11/26/2019
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  Enhanced claim edits to support correct coding principles and important information about Medicare AdvantagePosted: 11/20/2019
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  Avoid documentation cloningPosted: 11/1/2019
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  Processes for post-service appeals and grievances Posted: 10/9/2019
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  Claim investigation and corrected claim submission proceduresPosted: 9/17/2019
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  Now in effect: Enhanced claim edits to align with industry standard billing rules for injectable drugs and biological agentsPosted: 9/4/2019
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  Now in effect: New claim payment policies for multiple therapies Posted: 9/3/2019
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  Professional Injectable and Vaccine Fee Schedule updates effective October 1, 2019Posted: 8/26/2019
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  ICD-10 in Action: Chapter-specific guidelinesPosted: 8/15/2019
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  Enhanced claim edits to align with industry standard billing rules for injectable drugs and biological agents beginning September 1, 2019 Posted: 8/5/2019
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  Now in effect: Enhanced claim edits to align with industry standard billing rules for DME and P&O billing providers Posted: 8/5/2019
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  New claim payment policies for multiple therapies Posted: 8/1/2019
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  Billing and cost-sharing for individuals enrolled in the Qualified Medicare Beneficiary programPosted: 7/26/2019
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  National Drug Code submission guidelines for co-packaged products listed as kits and multi-level packaged productsPosted: 6/25/2019
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  Claim investigation and corrected claim submission proceduresPosted: 6/12/2019
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  Enhanced claim edits to align with industry standard billing rules for DME and P&O billing providers beginning August 1, 2019Posted: 6/12/2019
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  Enhanced claim edits to align with industry standard billing rules for injectable drugs and biological agents Posted: 6/3/2019
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  Professional Injectable and Vaccine Fee Schedule updates effective July 1, 2019Posted: 5/24/2019
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  Enhanced claim edits to align with industry standard billing rules for DME and P&O billing providersPosted: 4/15/2019
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  Claim reprocessing for multiple procedure payment reductions on certain diagnostic servicesPosted: 3/28/2019
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  Claim investigation and corrected claim submission proceduresPosted: 3/19/2019
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  Reminder: Guidelines for billing with taxonomy codesPosted: 3/7/2019
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  Professional Injectable and Vaccine Fee Schedule updates effective April 1, 2019Posted: 3/1/2019
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  Resolved: Overpayment impacting January 2019 capitation and PCP quality incentive payments for panels with Keystone 65 Focus Rx membership onlyPosted: 2/13/2019
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  Changes coming to application of Modifier 59 in 2019Posted: 1/11/2019
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  Overpayment impacting January 2019 capitation and PCP quality incentive payments for panels with Keystone 65 Focus Rx membership onlyPosted: 1/7/2019
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  Updated payer ID grids now available Posted: 1/7/2019
Bill
2018 Updates
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  Update: BCBSA high-dollar prepayment claims review policyPosted: 12/26/2018
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  Reminder: Enhanced claim edits to support correct coding principles and important information about self-funded groupsPosted: 12/14/2018
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  Billing guidelines for coverage of intrauterine devices (IUDs) Posted: 12/6/2018
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  Professional Injectable and Vaccine Fee Schedule updates effective January 1, 2019Posted: 11/29/2018
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  BCBSA high-dollar prepayment claims review policyPosted: 11/29/2018
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  Enhanced claim edits to support correct coding principles and important information about self-funded groupsPosted: 11/14/2018
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  Recent changes to CMS requirements and additions to Medicare Advantage AddendumsPosted: 11/12/2018
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  Updated payer ID grids now available Posted: 11/1/2018
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  Reminder: Reinstatement of edits for Excludes1 and Excludes2 notes Posted: 10/24/2018
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  Updated payer ID grids now available Posted: 10/2/2018
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  Reinstatement of edits for Excludes1 and Excludes2 notes Posted: 9/28/2018
- •
  Updated payer ID grids now availablePosted: 9/12/2018
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  Professional Injectable and Vaccine Fee Schedule updates effective October 1, 2018 Posted: 8/29/2018
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  Updated billing requirements for preventive colonoscopy and flexible sigmoidoscopyPosted: 8/23/2018
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  Updated payer ID grids now available Posted: 8/8/2018
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  Temporary edit suspension for Excludes1 and Excludes2 notesPosted: 8/7/2018
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  New Provider EOB message for QMB program claimsPosted: 8/3/2018
- •
  Claim denial issues and resolutionPosted: 7/19/2018
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  New account administrator for spending account paymentsPosted: 7/10/2018
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  Updated payer ID grids now available Posted: 7/2/2018
- •
  ICD-10 in Action: Coding guidelines and conventions – Excludes1 and Excludes2 notesPosted: 6/22/2018
- •
  Pass-through billing not permitted by IndependencePosted: 6/21/2018
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  Reminder: Billing and cost-sharing for individuals enrolled in the Qualified Medicare Beneficiary programPosted: 6/12/2018
- •
  Services eligible for reimbursement above the capitation ratePosted: 6/12/2018
- •
  Enhanced claim edits to support correct coding principles Posted: 6/11/2018
- •
  Important information for professional providersPosted: 6/1/2018
- •
  Updated payer ID grids now available Posted: 6/1/2018
- •
  Reminder: Claim investigation and corrected claim submission proceduresPosted: 5/25/2018
- •
  Billing of date ranges for DME and specialty pharmacy Posted: 5/24/2018
- •
  Update: Enhanced claim edits to support correct coding principles to begin in June 2018Posted: 5/15/2018
- •
  Updated payer ID grids now availablePosted: 5/1/2018
- •
  Reminder: Enhanced claim edits to support correct coding principles to begin in June 2018Posted: 4/24/2018
- •
  Updated payer ID grids now availablePosted: 4/10/2018
- •
  Updated code-to-code list now availablePosted: 4/2/2018
- •
  Enhanced claim edits to support correct coding principles to begin in June 2018Posted: 3/9/2018
- •
  Updated payer ID grids now available Posted: 3/6/2018
- •
  Professional Injectable and Vaccine Fee Schedule updates effective April 1, 2018 Posted: 3/1/2018
- •
  ICD-10 in Action: Common reporting errorsPosted: 2/12/2018
- •
  Changes made to the DME and P&O fee schedulePosted: 1/12/2018
- •
  Reminder: Guidelines for billing with taxonomy codes Posted: 1/11/2018
- •
  Updated payer ID grids now available Posted: 1/11/2018
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  ICD-10 in Action: Coding for seasonal activitiesPosted: 1/5/2018
Bill
2017 Updates
- •
  Updated Institutional Claims Resolution Matrix now availablePosted: 12/11/2017
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  ICD-10 in Action: Interpreting 'with' or 'in'Posted: 12/7/2017
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  Professional Injectable and Vaccine Fee Schedule updates effective January 1, 2018Posted: 11/30/2017
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  Reminder: Claim investigation and corrected claim submission proceduresPosted: 11/15/2017
- •
  ICD-10 in Action: “Code Also” instructional notePosted: 10/30/2017
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  Updated payer ID grids now availablePosted: 10/13/2017
- •
  Billing and cost-sharing for individuals enrolled in the Qualified Medicare Beneficiary ProgramPosted: 9/15/2017
- •
  Professional Injectable and Vaccine Fee Schedule updates effective October 1, 2017Posted: 9/6/2017
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  Reminder: Medically Unlikely Edits applied to professional and facility claimsPosted: 9/6/2017
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  Change to requirements for billing with POA indicator Posted: 9/1/2017
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  ICD-10 in Action: Code First coding conventionPosted: 8/31/2017
- •
  Test Your Knowledge – True or False: Conventions, general, and chapter-specific guidelines – August 2017Posted: 8/31/2017
- •
  Billing reminder for acute care hospitals and SNFsPosted: 7/31/2017
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  ICD-10 in Action: Coding sequence and coding specificity/unspecified codesPosted: 7/18/2017
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  Test your knowledge: Coding specificity – July 2017Posted: 7/18/2017
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  Reminder: Important information for professional providersPosted: 6/28/2017
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  Updated CMS-1500 toolkit and UB-04 guide now availablePosted: 6/5/2017
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  Professional Injectable and Vaccine Fee Schedule updates effective July 1, 2017Posted: 5/31/2017
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  Billing for habilitative and rehabilitative servicesPosted: 5/15/2017
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  Important information for professional providersPosted: 5/2/2017
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  Updated claims resolution matrices now availablePosted: 4/12/2017
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  Retraction: Proper billing guidelines for institutional ambulance claimsPosted: 4/5/2017
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  Billing for professional services during an inpatient stayPosted: 3/21/2017
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  Corrected claim resubmission requirementsPosted: 3/9/2017
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  Professional Injectable and Vaccine Fee Schedule updates effective April 1, 2017Posted: 3/2/2017
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  Reminder of billing requirements for anesthesia servicesPosted: 2/8/2017
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  Update: Our policy on direct and/or indirect third-party payments of member premiums and cost-sharingPosted: 1/23/2017
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  Important information regarding the 90-day grace period for APTC membersPosted: 1/18/2017
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  Prohibition on billing Medicare-Medicaid enrollees for Medicare cost-sharingPosted: 1/17/2017
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  Updated payer ID grids now availablePosted: 1/6/2017
Bill
2016 Updates
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  Professional Injectable and Vaccine Fee Schedule updates effective January 1, 2017Posted: 12/1/2016
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  Claim submission changes for oral surgeryPosted: 10/3/2016
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  Updated payer ID grids now availablePosted: 10/3/2016
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  Professional Injectable and Vaccine Fee Schedule updateseffective October 1, 2016Posted: 8/31/2016
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  Electronic claim resubmission requirementsPosted: 8/31/2016
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  Mapping change for vaginal delivery claimsPosted: 6/30/2016
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  Claim notifications and common ICD coding errors on paper and electronic claimsPosted: 6/30/2016
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  Changes in reimbursement displayPosted: 6/1/2016
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  Professional Injectable and Vaccine Fee Schedule updates effective July 1, 2016Posted: 6/1/2016
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  Important billing reminders for hospitals Posted: 6/1/2016
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  Reimbursement of emergency room servicesPosted: 4/29/2016
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  Reminder: Common ICD coding errors identified on paper and electronic claims Posted: 4/29/2016
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  Important reimbursement information for professional providers Posted: 4/29/2016
- •
  Billing preventive gynecological visits for Medicare Advantage membersPosted: 3/31/2016
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  Reminder: Transitioning outstanding A/R balancesPosted: 3/31/2016
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  Coming soon: Important reimbursement information for professional providersPosted: 3/31/2016
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  Billing for observation services when combined with other outpatient servicesPosted: 2/29/2016
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  Professional Injectable and Vaccine Fee Schedule updates effective April 1, 2016 Posted: 2/29/2016
- •
  New claims reporting requirements now in effect for home infusion vendors Posted: 2/29/2016
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  Update on APC reimbursementsPosted: 2/29/2016
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  Reminder: Common ICD coding errors identified on paper and electronic claims Posted: 1/29/2016
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  Upcoming changes to claims reporting requirements for home infusion providersPosted: 1/29/2016
Bill
2015 Updates
- •
  Updated payer ID grids now availablePosted: 12/30/2015
- •
  Upcoming changes to claims reporting requirements for home infusion providers Posted: 12/30/2015
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  Common ICD coding errors identified on paper and electronic claimsPosted: 12/1/2015
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  Updated payer ID grids available soonPosted: 12/1/2015
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  Professional Injectable and Vaccine Fee Schedule updates effective January 1, 2016 Posted: 12/1/2015
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  Reminder: Important billing information for modifiers 25 and –X{EPSU} and 59Posted: 10/30/2015
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  Updated UB-04 guide and CMS-1500 toolkit now availablePosted: 10/30/2015
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  Medical Nutrition Therapy coverage for Medicare Advantage members Posted: 9/1/2015
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  Professional Injectable and Vaccine Fee Schedule updates effective October 1, 2015 Posted: 9/1/2015
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  Updated CMS-1500 claim form resources now availablePosted: 7/31/2015
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  Reminder: Important billing information for modifier 25 and modifiers –X{EPSU} and 59Posted: 7/31/2015
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  Select standard fee schedules available on NaviNet^®Posted: 7/31/2015
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  Use the full member ID number when billing for service Posted: 7/31/2015
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  Claims processing requirements for PCPs rendering services to members in long-term care facilities Posted: 7/2/2015
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  Billing requirement for anesthesia claims Posted: 7/2/2015
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  Professional Injectable and Vaccine Fee Schedule updates effective July 1, 2015 Posted: 6/1/2015
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  Reminder: Transitioning outstanding Accounts Receivable balances to new platformPosted: 6/1/2015
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  Reminder: Important billing information for modifiers 25 and 59 Posted: 5/1/2015
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  Reminder: Billing requirements for billing multiple servicesPosted: 5/1/2015
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  Enforcing claims processing requirements Posted: 5/1/2015
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  Correction: Claim submission requirements when billing with place of service code 22Posted: 4/1/2015
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  EDI web resources updated Posted: 4/1/2015
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  Updated process for submitting an overpayment/refund request Posted: 4/1/2015
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  Claim submission requirements when billing with place of service code 22Posted: 3/2/2015
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  Important billing information for modifiers 25 and 59 Posted: 3/2/2015
- •
  Professional Injectable and Vaccine Fee Schedule updates effective April 1, 2015Posted: 3/2/2015
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  POA indicator and properly filling out claimsPosted: 3/2/2015
- •
  Proper screening colonoscopy billing for Medicare Advantage membersPosted: 3/2/2015
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  Additional HIPPS code requirements for certain SNF claims/encountersPosted: 1/30/2015
Bill
2014 Updates
- •
  Modifier 25 required for reporting removal of impacted cerumenPosted: 12/30/2014
- •
  Updated payer ID grids available soonPosted: 12/30/2014
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  Transitioning outstanding Accounts Receivable balancesto new platformPosted: 12/1/2014
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  Professional Injectable and Vaccine Fee Schedule updateseffective January 1, 2015Posted: 12/1/2014
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  Our policy on direct and/or indirect third-party payments Posted: 10/31/2014
- •
  Medicare supplemental claim rejectionsPosted: 10/1/2014
- •
  Use of new CMS-1500 (02/12) claim form requiredPosted: 8/28/2014
- •
  Professional Injectable and Vaccine Fee Schedule updates effective October 1, 2014Posted: 8/28/2014
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  Billing requirements for anesthesia claimsPosted: 8/28/2014
- •
  Upcoming changes to IBC’s post-service appeals and grievance processes Posted: 7/31/2014
- •
  Coding guidelines for spinal fusion proceduresPosted: 7/31/2014
- •
  Ensure successful submission of CMS-1500 claim forms and an updated toolkit now availablePosted: 7/31/2014
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  Reminder: Participating providers must submit all claims for IBC members to IBCPosted: 7/31/2014
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  Reminder: 90-day grace period for APTC membersPosted: 7/31/2014
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  HIPPS codes requirement for certain SNF and HHA claims/encountersPosted: 7/1/2014
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  Ensure successful electronic claims submissionsPosted: 7/1/2014
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  Participating providers must submit all claims for IBC members to IBCPosted: 7/1/2014
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  Upcoming changes to billing requirementsPosted: 5/30/2014
- •
  Professional Injectable and Vaccine Fee Schedule updates effective July 1, 2014Posted: 5/30/2014
- •
  Reminder: 90-day grace period for APTC membersPosted: 5/30/2014
- •
  Electronic claim resubmission requirementsPosted: 5/30/2014
- •
  Guidelines for billing with taxonomy codesPosted: 5/30/2014
- •
  Tips for submitting claims using the new CMS-1500 (02/12) claim formPosted: 5/1/2014
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  Updated payer ID grids now availablePosted: 5/1/2014
- •
  Use of new CMS-1500 (02/12) claim form now requiredPosted: 3/31/2014
- •
  Positive changes to the IBC standard fee schedule for certain professional providersPosted: 3/31/2014
- •
  Key changes to CMS-1500 claim form and updated toolkit now availablePosted: 2/28/2014
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  Reminder: 90-day grace period now in effectPosted: 2/28/2014
- •
  Reminder: Use a valid NPI for all claimsPosted: 2/28/2014
- •
  Professional Injectable and Vaccine Fee Schedule updates effective April 1, 2014Posted: 2/28/2014
- •
  90-day Grace Period now in effectPosted: 1/31/2014
- •
  Use a valid NPI for all claimsPosted: 1/9/2014
- •
  Updated payer ID grids now availablePosted: 1/9/2014
- •
  Reminder: Enforcement of industry standards related to platform transitionPosted: 1/3/2014
Bill
2013 Updates
- •
  Updated Claims Preprocessing Edits and Claims Resolution Document now availablePosted: 12/2/2013
- •
  Enforcement of industry standards related to platform transitionPosted: 12/2/2013
- •
  Medically Unlikely Edits now applied to professional and facility claimsPosted: 12/2/2013
- •
  Change in reimbursement display for multiple outpatient surgical proceduresPosted: 12/2/2013
- •
  Professional Injectable and Vaccine Fee Schedule updates effective January 1, 2014Posted: 12/2/2013
- •
  Revised time line for new CMS-1500 (02/12) claim formPosted: 12/2/2013
- •
  Guides available for new Provider EOB and Provider RemittancePosted: 11/1/2013
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  New alpha prefixes for some migrated members and updated payer ID gridsPosted: 11/1/2013
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  Changes to 835 transactions in dual claims-processing environmentPosted: 11/1/2013
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  Improved processes for identifying members subject to COB provisions and/or benefits exclusionsPosted: 11/1/2013
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  Updated CMS-1500 claim form effective January 6, 2014Posted: 10/2/2013
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  New member ID cards and submitting claims for members migrated to the new platformPosted: 10/2/2013
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  Upcoming changes to mom/baby claims submission processPosted: 10/2/2013
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  Bill Type 33X to be discontinuedPosted: 8/29/2013
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  Professional Injectable and Vaccine Fee Schedule updates effective October 1, 2013Posted: 8/29/2013
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  Updated payer ID grids now availablePosted: 7/1/2013
- •
  Reminder: Medicare Advantage PPO Network Sharing billing proceduresPosted: 5/31/2013
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  ZIP code requirement for all ambulance service claimsPosted: 5/31/2013
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  Professional Injectable and Vaccine Fee Schedule updates effective July 1, 2013Posted: 5/31/2013
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  Updated payer ID grids now availablePosted: 5/31/2013
- •
  Updated payer ID grids now availablePosted: 5/1/2013
- •
  QPM score program for measurement year 2012 phase two responses due March 26thPosted: 3/21/2013
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  Updated payer ID grids now availablePosted: 3/1/2013
- •
  Changes to billing procedures for nutrition counseling are now in effectPosted: 3/1/2013
- •
  Reminder: Nutrition counseling in a group setting not eligible for paymentPosted: 2/1/2013
Bill
2012 Updates
- •
  Professional Injectable and Vaccine Fee Schedule updates effective January 1, 2013Posted: 11/30/2012
- •
  Significant changes in 2013 to CPT^® codes for behavioral health servicesPosted: 11/30/2012
- •
  Nutrition counseling not eligible for payment in group settingPosted: 11/30/2012
- •
  Professional Injectable and Vaccine Fee Schedule updates effective October 1, 2012Posted: 8/31/2012
- •
  Billing ambulance services for Medicare Advantage PPO membersPosted: 8/31/2012
- •
  Clarification of billing guidelines for BlueCard^® claims for DME, independent clinical laboratory, and specialty pharmacy providersPosted: 8/31/2012
- •
  ICD-10 Spotlight: Know the codes (Drug underdosing)Posted: 6/29/2012
- •
  Updated payer ID grids now availablePosted: 6/29/2012
- •
  ClaimCheck^® upgrade and edit clarificationPosted: 6/29/2012
- •
  Professional Injectable and Vaccine Fee Schedule updates effective July 1, 2012Posted: 5/31/2012
- •
  Professional fee schedule changes effective July 1, 2012Posted: 5/1/2012
- •
  Professional Injectable and Vaccine Fee Schedule updates effective April 1, 2012Posted: 3/1/2012
- •
  Upcoming professional fee schedule changes for 2012Posted: 1/31/2012
Bill
2011 Updates
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  Updated payer ID grids now availablePosted: 12/29/2011
- •
  Reminder: Change to anesthesia claims payment methodology calculationPosted: 12/5/2011
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  Professional Injectable and Vaccine Fee Schedule updates effective January 1, 2012Posted: 12/1/2011
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  Claims Preprocessing Edits Claims Resolution Document updated for HIPAA 5010Posted: 11/1/2011
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  Professional Injectable and Vaccine Fee Schedule updates effective October 1, 2011Posted: 9/1/2011
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  Procedures for billing multiple servicesPosted: 7/28/2011
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  Updated payer ID grids now availablePosted: 7/1/2011

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