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Blue Review - Subject Archive

Subject Archive: Claims

The links below take you to the appropriate edition of Blue Review.
We have included a page number to assist you in finding the article.

Article Title Quarter/Year Page
Predetermination Process for the Respiratory Syncytial Virus    7th/2010 1
American Imaging Management to launch new, improved provider homepage    7th/2010 3,4
New code auditing tool will improve overall claims management performance    7th/2010 4
Calling us for claim status?    7th/2010 4-5
Be prepared: Know the facts about ANSI 5010 and ICD-10    7th/2010 6-8
Correction: Billing with National Drug Codes (NDCs)    7th/2010 8
Place of Service: Office versus Outpatient    7th/2010 8,9
Modifier 22: BCBSTX to review surgical claims    7th/2010 9
iEXCHANGE - pended cases    7th/2010 9
Useful information when billing for a Rapid Desensitization Procedure    7th/2010 10
Preauthorization and the Interactive Voice Response (IVR) phone system    7th/2010 10,11
Electronic claims with NPI-related errors    7th/2010 11
Technical and professional components    7th/2010 12,13
AIM RQI reminder    7th/2010 13
Surgical procedures performed in the physician's office    7th/2010 13
Quest Diagnostic, Inc., is new, exclusive HMO and preferred statewide PPO/POS clinical reference lab provider    7th/2010 13,14
BlueChoice Solutions Large Employer Groups List    7th/2010 14
Improvements to the medical records process for BlueCard claims    7th/2010 15
Fee schedule updates    7th/2010 15
Pass-through billing    7th/2010 15,16
Contracted physicians and other professional providers must file claims    7th/2010 16
No additional medical records needed    7th/2010 17
Importance of obtaining preauthorizations for initial stay and add-on days    7th/2010 17
Urgent versus standard predeterminations    7th/2010 17
Avoidance of delay in claims pending COB information    7th/2010 18
QVT (quantity versus time) limits    7th/2010 18
Provider Billing for non-covered services    7th/2010 18
Predetermination Process for the Respiratory Syncytial Virus    6th/2010 2,3
Hospital Acquired Conditions' and 'Never Events'    6th/2010 3
Useful information when billing for a Rapid Desensitization Procedure    6th/2010 4
Supervision of Physician Assistant, Advance Practice Nurse or Certified Registered Nurse First Assistant    6th/2010 5
Clear Claim ConnectionTM available to BCBSTX physicians and other professional providers    6th/2010 6,7
Technical and professional components    6th/2010 7
AIM RQI reminder    6th/2010 7
Surgical procedures performed in the physician's office    6th/2010 7
Fee schedule updates    6th/2010 9
BlueChoice Solutions Large Employer Groups List    6th/2010 9
Improvements to the medical records process for BlueCard claims    6th/2010 9
Claims Pass-through billing    6th/2010 9,10
Contracted physicians and other professional providers must file claims    6th/2010 10
No additional medical records needed    6th/2010 11
Importance of obtaining preauthorization's for initial stay and add-on days    6th/2010 11
Urgent versus standard predeterminations    6th/2010 11
Avoidance of delay in claims pending COB information    6th/2010 12
Billing for non-covered services    6th/2010 12
When requesting claims status, the Web trumps the telephone    5th/2010 1
Electronic Refund Management tool is an excellent alternative to submitting a paper refund request    5th/2010 1,2
Claims EFT, ERA and EPS: Beyond the Basics, Part 2    5th/2010 2-4
'Hospital Acquired Conditions' and 'Never Events'    5th/2010 4,5
Copayments, coinsurance and some benefits change for HealthSelect plan    5th/2010 5
Electronic claims with NPI-related errors set to reject Aug. 1, 2010    5th/2010 5,6
Supervision of Physician Assistant, Advanced Practice Nurse or Certified Registered Nurse First Assistant    5th/2010 6,7
Clear Claim ConnectionTM available to BCBSTX physicians and other professional providers    5th/2010 7,8
Technical and professional components    5th/2010 8
Surgical procedures performed in the physician's office    5th/2010 8
AIM RQI reminder    5th/2010 8,9
Quest Diagnostic, Inc., is new, exclusive HMO and preferred statewide PPO/POS clinical reference lab    5th/2010 9
Improvements to the medical records process for BlueCard claims    5th/2010 10
BlueChoice Solutions Large Employer Groups List    5th/2010 10
Fee schedule updates    5th/2010 10
Pass-through billing    5th/2010 10,11
Contracted physicians and other professional providers must file claims    5th/2010 11
Urgent versus standard predeterminations    5th/2010 12
No additional medical records needed    5th/2010 12
Urgent versus standard predeterminations    5th/2010 12
Importance of obtaining preauthorizations for initial stay and add-on days    5th/2010 12,13
Avoidance of delay in claims pending COB information    5th/2010 13
Billing for non-covered services    5th/2010 13
Appropriate billing when a patient has reached a benefit max   4th/2010 2
Check reissue request for providers   4th/2010 5
Hospital room rate notification   4th/2010 5
Significant edits related to ClaimCheck denials   4th/2010 5,6
The principles of medical-record documentation   4th/2010 6-8
EFT, ERA, and EPS: Beyond the Basics, Part 1   4th/2010 8-10
Electronic claims with NPI-related errors set to reject August 1, 2010   4th/2010 10
Interactive Voice response (IVR) System   4th/2010 10
Electronic claims with NPI-related errors set to reject August 1, 2010   4th/2010 10
Supervision of Physician Assistant, Advanced Practice Nurse, or Certified Registered Nurse First Assistant   4th/2010 10,11
Clear Claim ConnectionTM available to BCBSTX providers   4th/2010 11,12
AIM RQI reminder   4th/2010 12
BlueChoice Solutions large employer groups list   4th/2010 13,14
Fee schedule updates   4th/2010 14
Improvements to the medical records process for BlueCard claims   4th/2010 14
Pass-through billing   4th/2010 14
Contracted providers must file claims   4th/2010 14,15
Importance of obtaining pre-authorizations for initial stay and add-on days   4th/2010 16
No additional medical records needed   4th/2010 16
Avoidance of delay in claims pending COB information   4th/2010 16,17
Billing for non-covered services   4th/2010 17
Physical, occupational and speech therapy services billed with an Evaluation & Management Code (E&M)   4th/2010 N/A
Outpatient Preauthorization Requirement Updates   3rd/2010 1
Billing with National Drug Codes (NDCs)   3rd/2010 1-3
Clear Claim ConnectionTM available to BCBSTX providers   3rd/2010 4
EFT, ERA, and EPS Survey Results   3rd/2010 11
Multiple surgery pricing per session methodology   3rd/2010 12
Electronic claims with NPI-related errors set to reject August 1, 2010   3rd/2010 13
Physical, occupational and speech therapy services billed with an Evaluation & Management Code (E&M)   3rd/2010 13
AIM RQI reminder   3rd/2010 14
Fee schedule updates   3rd/2010 15,16
Pass-through billing   3rd/2010 16
Reminder - Contracted providers must file claims   3rd/2010 16
Improvements to the medical records process for BlueCard claims   3rd/2010 16
Avoidance of delay in claims pending COB information   3rd/2010 18
Billing for non-covered services   3rd/2010 18
Importance of obtaining preauthorizations for initial stay and add-on days   3rd/2010 18
To new users of EFT, ERA and EPS   2nd/2010 2
PCS to EPS: 30-day transition reminder   2nd/2010 3
Electronic transactions - 2010 holiday schedule reminder   2nd/2010 3,4
Changes affect Walmart associates in 2010   2nd/2010 4,5
Pharmacy updates: pharmacy compounding   2nd/2010 5-8
Attention specialty care physicians…Need to see if a referral has been issued to you?   2nd/2010 10,11
Electronic submissions can help expedite secondary claim payments   2nd/2010 11,12
Evidence-based measures evaluation   2nd/2010 13
Change to claims run-out period for U.S. Virgin Islands Extended to April 16, 2010   2nd/2010 14
AIM RQI Reminder   2nd/2010 15
Outpatient Clinical Reference Laboratory for HMO Blue Texas   2nd/2010 15,16
BlueChoice Solutions Large Employer Groups List   2nd/2010 16
Fee schedule updates   2nd/2010 16,17
Improvements to the medical records process for BlueCard claims   2nd/2010 17
Pass-through billing   2nd/2010 17
Medical Policy Disclosure   2nd/2010 17,18
Draft medical policy review   2nd/2010 18
Importance of obtaining preauthorizations for initial stay and add-on days   2nd/2010 19
Availity's new claims research tool offers
speed, accuracy
  
1st/2010 1
Reminder! New plan years have begun, verify member ID cards   1st/2010 2
Special note about Walmart patients and their ID cards   1st/2010 2
Important provider information on new wellness initiatives for federal employees under the Service Benefit Plan   1st/2010 3-5
Medical offices are gaining the paperless advantage   1st/2010 5
Texas amends age limit for autism spectrum disorder benefits   1st/2010 5,6
Are you using paper claims to bill unlisted procedure codes for drugs and injections?   1st/2010 6,7
La Cruz Azul and U.S. Virgin Island claims run-out period   1st/2010 10,11
Upcoming changes regarding specialty medications   1st/2010 13
AIM ProviderPortal enhancement   1st/2010 14
Are you billing for services performed on yourself or a family member?   1st/2010 14
New HRA benefit for Kohler employees   1st/2010 14
Step Therapy and Prior Authorization programs   1st/2010 14,15
Medical policy disclosure   1st/2010 15
Draft medical policy review   1st/2010 15
Urgent versus standard predeterminations   1st/2010 15,16
No additional medical records needed   1st/2010 16
Importance of obtaining preauthorizations for initial stay and add-on days   1st/2010 16
QVT (quantity versus time) limits   1st/2010 17
Preferred drug list   1st/2010 17
PrimeMail utilizers for specialty medications (all groups)   1st/2010 17
AIM RQI reminder   1st/2010 17,18
BlueChoice Solutions large employer group list as of December 2009   1st/2010 19
Outpatient clinical reference laboratory for HMO Blue Texas   1st/2010 22
Fee schedule updates   1st/2010 19,20
Improvements to the medical records process for BlueCard claims   1st/2010 21
More than health care, Season of Life program is health caring   3rd/2009 1
Special coverage for H1N1 vaccine   3rd/2009 1
Paperless transactions are gaining popularity   3rd/2009 3
Say goodbye to your paper provider claim summary   3rd/2009 3
Coordination of benefits   3rd/2009 5,6
BlueEdge product portfolio   3rd/2009 6,7
Taxonomy codes - definition and claims use   3rd/2009 8,9
Claim appeal/reconsideration review process   3rd/2009 9,10
Medicare-related claims for BlueCard members   3rd/2009 12
Reminder - Contracted providers must file claims   3rd/2009 12
Crossover process saves time and money for Medicare Part A & B electronic claims   3rd/2009 13
Fee schedule updates effective in August   3rd/2009 14,15
Proper speech therapy billing   3rd/2009 15
American Imaging order requests now approved online   3rd/2009 15,16
Urgent care center services billed using CPT code S9088   3rd/2009 16
Billing errors on CMS 1500: submitting a corrected
claims
  
3rd/2009 16
Reasons for returned paper claims   3rd/2009 17
AIM RQI reminder   3rd/2009 17
Draft medical policy review   3rd/2009 17
Pass-through billing   3rd/2009 18
Reminder - Contracted providers must file claims   3rd/2009 18
When a patient loses coverage   2nd/2009 1,2
Thinking outside the mailbox: Survey examines provider perspective on paperless transactions   2nd/2009 2,3
New online tool for managing refunds launches
this month
  
2nd/2009 3,4
Fee schedule updates effective in August   2nd/2009 5
Improvements to the medical records process for BlueCard claims   2nd/2009 6
NDC number key to proper reimbursement for J-code drugs   2nd/2009 7
Are you billing for compound drugs?   2nd/2009 8
Submitting CPT 99000 with Modifier 59   2nd/2009 8
Medical record documentation guidelines (predeterminations/claims)   2nd/2009 9
TRS-ActiveCare benefit change for bariatric surgery effective Sept.1   2nd/2009 11,12
PPIs added to City of Houston step therapy program   2nd/2009 12,13
Professional charges for services performed by a physician in a hospital setting   2nd/2009 13
Pass-through billing   2nd/2009 13
Identifying primary insurance when seeing BCBSTX members over Age 65   2nd/2009 13
Draft medical policy review   2nd/2009 14
Medical policy disclosure   2nd/2009 14
BlueChoice solutions large employer groups list   2nd/2009 14,15
Updates to procedure codes   2nd/2009 15
AIM RQI reminder   2nd/2009 16
Billing for non-covered services   2nd/2009 17
Reminder - Contracted providers must file claims   2nd/2009 17
Simple rule: include the onset/occurrence date   2nd/2009 18
Billing for allied professionals   2nd/2009 17
Simple rule: include the onset/occurrence date   2nd/2009 18