Blue Review newsletter
- 12/24/25 Prior Authorization Changes for Some Commercial and Government Program Members
- 12/23/25 Prior Authorization Changes for Medicare Advantage Members, Effective Jan. 1, 2026
- 12/23/25 See Changes to Coverage for Breast Cancer Screening
- 12/22/25 Clinical Payment and Coding Policy Updates
- 12/17/25 Update Your Records for New Blue Cross Group Medicare Advantage Open Access (PPO)SM Members
- 12/15/25 Medical Records Collection for Federal Employee Program® Begins in February
- 12/09/25 Provide Records to Support Quality Care for Medicare Advantage Members
- 12/05/25 Remind Our Members About Cervical and Breast Cancer Screenings
- 12/04/25 Follow-Up Care Is Recommended for Children Prescribed ADHD Medication
- 12/01/25 We’re Reviewing Existing Prior Authorization Exemptions
- 12/01/25 We’re Renaming Clinical Payment and Coding Policies to Reimbursement Policies
- 11/26/25 Enhanced Diagnosis Claim Edits to Follow CMS Guidelines
- 11/25/25 Remember to use Proper Coding for Evaluation and Management Services, Modifiers and Oncology Drugs and Services for Medicare and Medicaid Claims
- 11/24/25 Clinical Payment and Coding Policy Updates
- 11/24/25 Prior Authorization Changes for Some Government Program Members, Effective Jan. 1, 2026
- 11/21/25 BlueApprovRSM To Accept Concurrent Reviews and Extensions for Behavioral Health Services: Attend a Training
- 11/17/25 Update: Paid Claims Editing To Be Enhanced in April 2026 for Medicaid and Medicare Advantage Members
- 11/17/25 Survey Reminder: Marketplace and Commercial Members Rate Satisfaction with Providers
- 11/14/25 Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)SM 2024 Program Summary
- 11/13/25 Earn Continuing Education Credit: Webinar on Autism Spectrum Disorder
- 11/12/25 Keep Your Record ID Active To Prevent Network Termination
- 11/11/25 See Updates to Behavioral Health Clinical Practice Guidelines
- 11/06/25 Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2026 – Part 1
- 10/31/25 Prior Authorization Changes for Some Commercial Members, Effective Jan. 1, 2026
- 10/29/25 Clinical Payment and Coding Policy Updates
- 10/22/25 Availity® Essentials Claim Status Tool Updates
- 10/21/25 We’re Updating Our Payment Systems to Help Improve Efficiencies
- 10/21/25 Updates on Managing Your Data in Availity® Essentials
- 10/14/25 Verify Your Directory Information Every 90 Days
- 10/09/25 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2025 – Part 2
- 10/03/25 Encourage Annual Eye Exams for Members with Diabetes
- 10/03/25 Reminder on Specialist Referrals for Teacher Retirement System Plans
- 10/01/25 Prior Authorization Changes for Some Commercial and Government Program Members, Effective Jan. 1, 2026
- 9/25/25 New Coding Policy for Psychiatry/Psychotherapy Services for Professional Providers
- 9/23/25 Ask Members to Complete a Depression Screening
- 9/23/25 Clinical Payment and Coding Policy Updates
- 9/23/25 Member Benefit Coverage for Viscosupplementation for Osteoarthritis will End Jan. 1, 2026
- 9/22/25 We’re Reducing Prior Authorization Response Times for Medicare Members
- 9/19/25 Support Care Coordination after Hospital Discharges
- 9/18/25 Access New Resource on Quality Measures in Availity® Essentials
- 9/17/25 Survey Results: Commercial Members Rate Health Care Experiences
- 9/17/25 Look for Your Medicare Advantage Access and Availability Survey
- 9/12/25 Encourage Routine Screening to Detect Breast Cancer Early
- 9/11/25 Encourage Our Members to Adhere to Statin Therapy As Prescribed
- 9/03/25 Discuss the Flu Vaccine with Our Members
- 9/02/25 Changes to Medical Policies
- 9/02/25 Prior Authorization Changes for Some Commercial Members, Effective Oct. 1, 2025
- 8/29/25 Prior Authorization Exemptions Reviewed for Jan. 1 through June 30, 2025
- 8/27/25 Watch for Updated Out-of-area Member ID Cards with No Suitcase Logo
- 8/25/25 Clinical Payment and Coding Policy Updates
- 8/20/25 Avoid Antibiotics for Acute Bronchitis and Other Viruses
- 8/18/25 PEAQSM Physician Performance Insight Reports Are Now Available
- 8/15/25 Five New Claims Editing Rules will be Implemented November 2025
- 8/14/25 Encourage Human Papillomavirus Vaccination to Protect Against Cancers Later in Life
- 8/13/25 Use Shared Decision-Making Aids to Help Guide Care Choices
- 8/11/25 Consider Behavioral Health Evaluations During Hospital Stays
- 8/05/25 Pharmacy Program Quarterly Update Changes Effective Oct. 1, 2025 – Part 1
- 8/01/25 We’re Reviewing New Prior Authorization Exemptions
- 7/29/25 Follow Guidelines for Making Physician Referrals for HMO Members
- 7/29/25 Clinical Payment and Coding Policy Updates
- 7/25/25 Provide Records to Support Risk Adjustment Data Validation Audit
- 7/24/25 ICD-10-CM Z Codes Help Us Track Members’ Social Needs
- 7/23/25 Review New Clinical Practice Guideline on Hepatitis C
- 7/23/25 Behavioral Health Services No Longer Administered by Magellan Healthcare®, Effective Jan. 1, 2026
- 7/22/25 See Our BlueCard® Program Checklist for Out-of-Area Member Claims
- 7/21/25 Providers with Medicaid: Encourage Members to Use Virtual Visits for Urgent Care After Hours
- 7/18/25 Update: Your NICU Claims Submissions Should Match Prior Authorization Levels of Care
- 7/15/25 Identify Your First-Responder and Sign Language Services for HealthSelect of Texas® Members
- 7/15/25 Review Reminder on Billing Point-of-Use Convenience Kits
- 7/10/25 Verify Your Directory Information Every 90 Days
- 7/07/25 Encourage Pediatric Well-Child Visits and Immunizations
- 7/02/25 Pharmacy Program Quarterly Update Changes Effective July 1, 2025 – Part 2
- 7/01/25 Review of Rescinded Prior Authorization Exemptions for Jan. 1 Through June 30, 2025
- 7/01/25 2025 Prior Authorization Exemption Renewal Results Now Available
- 6/30/25 Prior Authorization Code Updates for Medicare Advantage, Effective Oct. 1, 2025
- 6/27/25 Prior Authorization Code Changes for Commercial Members, Effective Oct. 1, 2025
- 6/24/25 Clinical Payment and Coding Policy Updates
- 6/24/25 Watch for Our Provider Availability and Access Survey
- 6/23/25 Review Updates to Clinical Practice and Preventive Care Guidelines
- 6/20/25 ClaimsXten™ Code Update Effective Aug. 18, 2025
- 6/18/25 Encourage Medicare Members to Respond to Health Outcomes Survey
- 6/17/25 Code Effectively to Earn Additional Incentive Payments on Medicare Advantage Claims
- 6/11/25 Provider Rights and Responsibilities
- 6/11/25 Member Rights and Responsibilities
- 6/03/25 Use Simplified Referral Form for American Indian/Alaska Native Limited Cost Share Plans
- 6/02/25 Encourage Routine Vaccines and Well-Care Visits for Adolescents
- 5/30/25 Postponed: Enhanced Claim Edit for Oncology Drugs and Services for Government Programs
- 5/29/25 Providers with Unused Record IDs May be Terminated from Networks
- 5/29/25 2024 Survey Results: Marketplace Members Rate Satisfaction with Providers
- 5/28/25 Prior Authorization Code Changes for Commercial Members, Effective July 1, 2025
- 5/28/25 Verify Your Directory Information Every 90 Days
- 5/27/25 Clinical Payment and Coding Policy Updates
- 5/23/25 Update: Behavioral Health Substance Use Criteria for Utilization Management
- 5/22/25 Claims Reminders for Behavioral Health Services
- 5/20/25 Update: New Home Delivery Pharmacy Service to Fill Members’ Injectable GLP-1 Prescriptions
- 5/19/25 New Coding Policy for Global Obstetrical Maternity Services
- 5/13/25 Quality Measures Track Diabetes Care
- 5/09/25 Update: Access BlueApprovRSM in Availity® Authorizations, Effective in June 2025
- 5/09/25 Behavioral Health Resources for Providers
- 5/06/25 Pharmacy Program Quarterly Update Changes Effective July 1, 2025 – Part 1
- 4/28/25 Clinical Payment and Coding Policy Updates
- 4/24/25 Your NICU Claims Submissions Should Match Prior Authorization Levels of Care Effective Aug. 1, 2025
- 4/09/25 Reinforce Prenatal and Postpartum Care to Support Whole Health
- 4/07/25 Behavioral Health Documentation to be Reviewed for Medicaid Members
- 4/03/25 Pharmacy Program Quarterly Update Changes Effective April 1, 2025 – Part 2
- 4/02/25 Prior Authorization Code Changes for Commercial Members, Effective July 1, 2025
- 4/02/25 Prior Authorization Code Updates for Medicare Advantage, Effective July 1, 2025
- 3/27/25 Clinical Payment and Coding Policy Updates
- 3/26/25 Clinical Series Program Offers Education on Pediatric Care
- 3/25/25 New Coding Policy for Lactation Support Services Effective June 26, 2025
- 3/19/25 Cigna Healthcare Medicare Advantage Transaction Complete
- 3/17/25 Watch for Our Annual Satisfaction Survey
- 3/14/25 Update Your Records with New Member ID Numbers
- 3/13/25 Quality Measures Track Treatment and Follow-Up Visits for Substance Use Disorders
- 3/12/25 Policy for Billing Telemedicine and Telehealth Services Updated, Effective Jan. 1, 2025
- 3/05/25 Earn Continuing Education Credit in Webinar on Behavioral Health in Older Adults
- 3/01/25 Prior Authorization Exemptions Reviewed for July 1 through Dec. 31, 2024
- 2/27/25 Alacura to Manage Medical Transportation for TRS Participants, Effective June 1, 2025
- 2/25/25 Clinical Payment and Coding Policy Updates
- 2/25/25 New Data on Quality Measures for Reporting Year 2023
- 2/21/25 Claims Review to Be Enhanced for Oncology Drugs and Services for Government Programs, Effective June 1, 2025
- 2/14/25 Education and Residency Information Required for Directory
- 2/14/25 Encourage Follow-up Care after Hospital Visits for Mental Health
- 2/12/25 Has Your Information Changed? Update Us and the NPI Registry
- 2/07/25 Utilization Management Review Paused for Advanced Imaging Site of Care
- 2/06/25 Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)SM 2023 Program Summary
- 2/05/25 Discuss Colon Health and Preventive Screening with Our Members
- 2/03/25 Pharmacy Program Quarterly Update Changes Effective April 1, 2025 – Part 1
- 1/28/25 Two Annual Surveys Track Commercial Members’ Health Care Experiences
- 1/28/25 CPCP006 Preventive Services Policy Updated Effective 02/01/2025
- 1/27/25 Encourage Medicare Advantage Members to Respond to Survey on Health Care Experiences
- 1/24/25 Update: Medical Policy Updates for Self-Administered Drugs Effective April 15, 2025
- 1/23/25 Patients in the Qualified Medicare Beneficiary Program Should Not Be Billed
- 1/23/25 Hospitals Must Provide Notice to Members Under Outpatient Observation for More Than 24 Hours
- 1/21/25 Quality Measures Help Track Our Members’ Heart Health
- 1/17/25 Pharmacy Program Quarterly Update Changes Effective Jan. 1, 2025 – Part 2
- 1/16/25 Prior Authorization Code Updates for Medicare Advantage Members Effective April 1, 2025
- 1/15/25 Avoid the Inappropriate Use of Antipsychotic Medication in Anxiety Disorders
- 1/08/25 Policy Revised on Revenue Codes Requiring Supporting Codes for Outpatient Facility Claims, Effective April 14, 2025
- 1/08/25 Contracted Providers Must File Claims
- 1/07/25 Update: Routine Services and Supplies - Updated 01/28/2025
- 1/07/25 Annual Review: CPCP025 Corrected Claim Submission Updated Effective 01/08/2025
- 1/06/25 Prior Authorization Code Changes for Commercial Members Effective April 1, 2025
- 1/06/25 Annual Review: CPCP030 Point-of-Care Ultrasound (POCUS) Examination Policy Updated
- 1/02/25 CPCP041 Sepsis Policy Updated Effective 04/01/2025
- 1/02/25 Update: Behavioral Health Substance Use Criteria for Utilization Management