2020 News

December 2020 Medical Policy Updates

Medical Policies | January 1, 2021

Here are the medical policy updates made in December 2020.

Prior Authorizations for MUGA Scan and Myocardial Perfusion Imaging

Prior Authorization,NIA Magellan | December 22, 2020

Change to National Imaging Associates (NIA) Magellan Healthcare prior authorizations.

Reminder: Genetic Counseling Prior to Genetic Testing

Serving Members,Claims | December 3, 2020

Prior to rendering genetic testing services for germline disorders, it is required that the member has documented genetic counseling on file.

November 2020 Medical Policy Updates

Medical Policies | November 30, 2020

Here are the medical policy updates that were made in November 2020.

Medical Policy Updates October 2020

Medical Policies | November 1, 2020

These are the medical policy updates that were made in October 2020.

Outpatient Prior Authorizations for Highmark Members

BlueCard | October 21, 2020

Highmark is expanding their prior authorization requirements for certain outpatient services.

Drug Cost Transparency Tools Available for Boeing Group Members

BlueCard | October 15, 2020

New tools are available for Blue Cross and Blue Shield of Illinois (BCBSIL) members enrolled in a group Boeing-sponsored medical plan or Boeing Medicare Part D prescription drug plan through Blue Cross Group Medicare Rx (PDP)SM and their health care providers. Boeing group member ID numbers start with these prefixes: BBE, BEM, BHP, BNK, BRG, BYR.

NIA Authorization Determination Notification Change

Prior Authorization,NIA Magellan | October 12, 2020

Effective Oct. 1, 2020, NIA discontinued the phone call to providers providing them with authorization determinations.

PCMH Kids

Serving Members | October 9, 2020

BlueCross BlueShield of South Carolina is pleased to announce the update and expansion of our pediatric patient-care medical home (PCMH) program, PCMH Kids.

UPDATE: CR Modifier

COVID-19,Claims | October 2, 2020

Now that explicit coding has been established to help identify COVID-19 related services, the CR modifier is no longer required on claims.

Medical Policy Updates September 2020

Medical Policies | October 1, 2020

These are the medical policy updates that were made in September 2020.

New Medical Policy: Minimal Residual Disease

Medical Policies | September 30, 2020

Effective Jan. 1, 2021, BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan will implement a new medical policy addressing better ways of detecting minimal residual disease.

CPT Code C9803

COVID-19,Claims | September 25, 2020

On July 1, 2020, the Centers for Medicare and Medicaid Services (CMS) released the CPT code C9803, which replaced the CPT codes G2023 and G2024.

My Health Planner — A Digital Medical Management App Connecting Patients to Care

Serving Members | September 23, 2020

My Health Planner is a new digital medical management app available to all BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan members identified for case management services as well as those who are identified as high or medium risk disease management (DM).

New My Insurance Manager (MIM) Feature Coming Soon

Prior Authorization,Enrollment,Serving Members,Claims | September 4, 2020

We’re adding a new feature to My Insurance Manager to better secure your user account.

Reminder: File Federal Employee Program (FEP) Dental Claims Electronically

Claims | September 1, 2020

FEP dental providers can submit claims (837) via clearinghouse with payer ID 402 and receive payments electronically, effective June 19, 2020.

August 2020 Medical Policy Updates

Medical Policies | August 31, 2020

Here is the list of medical policy updates that were made in August 2020.

South Carolina Student Health Vision Benefits

Serving Members | August 26, 2020

Members with this health plan have vision benefits, which are subject to a $20 copayment when services are rendered by an in-network provider and should not be billed more than their copayment.

Additional Codes in the Avalon Laboratory Prior Authorization List

Prior Authorization | August 24, 2020

Effective Sept. 1, 2020 the Avalon prior authorization list has been updated to include additional codes. View them here.

Alpha Prefix: YPO

Serving Members | August 24, 2020

The YPO alpha prefix is one that North Carolina has assigned to all members with a Blue plan in Maryland that participate in the Away From Home Care (AFHC) program.

U0002 and U0003 Coding Reminder

COVID-19,Claims | August 13, 2020

BlueCross and BlueChoice® will only cover one test per day for the same member.

Healthy Blue Provider Enrollment Requirement

Enrollment | August 13, 2020

One requirement for Healthy Blue is confirmation that you have completed Cultural Competency training.

July 2020 Medical Policy Updates

Medical Policies | July 31, 2020

These are the medical policy updates that were made in July 2020.

June 2020 Medical Policy Updates

Medical Policies | June 30, 2020

Here are the medical policies that were updated in June 2020.

Strong Password Protection

Serving Members | June 25, 2020

Safeguarding member personal information can begin with creating a strong password. Having a strong password provides protection from financial fraud and identity theft for you and our members.

New Policy: Gamma-Glutamyl Transferase

Medical Policies | June 17, 2020

Effective, Aug. 15, 2020, BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan will implement a new medical policy regarding the testing of the enzyme GGT.

South Carolina Student Health Insurance Referral Update

Serving Members | June 10, 2020

Referrals are no longer required before students could be seen for services. 

File Federal Employee Program (FEP) Dental Claims Electronically

Dental,Claims | May 28, 2020

Effective June 19, 2020, dental providers can submit claims electronically (837) via clearinghouse with payer ID 402.

Using the Correct Modifiers for Anesthesia Claims

Claims | May 28, 2020

Anesthesia services submitted to BlueCross BlueShield of South Carolina and BlueChoice® HealthPlan should be submitted for reimbursement using the American Society of Anesthesia (ASA) codes and appropriate modifiers.

Complete Accident Questionnaires in My Health Toolkit

Serving Members,Claims | May 20, 2020

BlueCross BlueShield of South Carolina members will be able to complete the required accident questionnaire for pending claims using My Health Toolkit®.

April 2020 Medical Policy Updates

Medical Policies | April 30, 2020

Here are the medical policy updates that were made in April 2020.

Reminder: Notice Delivery for Beneficiaries Receiving Institutional Care

Medicare Advantage,COVID-19,Claims | April 21, 2020

Medicare Advantage institutional providers, view CMS’ memorandum, Flexibilities for Notice Delivery for Beneficiaries Receiving Institutional Care, for guidance on delivering the below notices to beneficiaries if being treated with suspected or confirmed COVID-19 symptoms.

Digital ID Card

Serving Members | April 1, 2020

BlueCross BlueShield South Carolina and BlueChoice® HealthPlan South Carolina allow members to access digital copies of their ID cards through My Health Toolkit®.

March 2020 Medical Policy Updates

Medical Policies | March 31, 2020

Here are the medical policy updates that were made in March of 2020.

Use RadMD for Radiology Prior Authorizations

Prior Authorization,NIA Magellan | March 24, 2020

Using RadMD is the quickest way to get radiology prior authorizations.

February 2020 Medical Policy Updates

Medical Policies | February 29, 2020

Here are the medical policy changes that were made in February 2020.

Prior Authorizations for MUGA Scan and Myocardial Perfusion Imaging

Prior Authorization,NIA Magellan | February 17, 2020

Change to National Imaging Associates (NIA) Magellan Healthcare prior authorizations.

January 2020 Medical Policy Updates

Medical Policies | January 31, 2020

Here are the medical policy updates that were made in January 2020.

A New Way to Manage Prescription and Medical Specialty Drugs

Pharmacy | January 1, 2020

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan now have a new pharmacy vendor.

Medicare Billing for Opioid Treatment Programs

Pharmacy,Medicare Advantage | January 1, 2020

Beginning Jan. 1, 2020, Medicare will cover opioid use disorder (OUD) treatment services for Medicare beneficiaries when performed by Opioid Treatment Program (OTP) providers.