Update on AmeriHealth Caritas EFT Deadline

AmeriHealth Caritas EFT Enrollment Deadline Extended to December 1

AmeriHealth Caritas North Carolina uses ECHO Health Inc, a partner of Change Healthcare, for electronic payment processing. There are no fees to receive a direct payment from AmeriHealth Caritas North Carolina via EFT or to receive an Electronic Remittance Advice (ERA).

All providers must enroll in EFT. To enroll in EFT with ECHO Health, providers must have received a payment via ECHO. To support providers in registering, AmeriHealth Caritas North Carolina is issuing paper checks and providing a direct link to providers to enroll in EFT for their AmeriHealth Caritas North Carolina payments. Please use the information on the Remittance Advice and the check stub to enroll in EFT. To enroll please visit https://enrollments.echohealthinc.com/efteradirect/enroll.

Providers who are already enrolled in ECHO for payments from other payers may have agreed to an all payor fee. They can choose to get direct payments for AmeriHealth Caritas North Carolina with no associated vendor fees by calling ECHO Health at 888-834-3511.

After December 1, providers that have not enrolled in EFT will be paid via virtual credit card (VCC). There is a fee charged by the card merchant for VCC payments.

If you have concerns, please contact Peggy Vickery, Interim Director of Provider Network Management, at 843-569-4630 or contact your dedicated ACNC account executive.

BCBSNC Updates: March 7, 2016

The following are the most recent updates and important notices from BCBSNC:

Release Dates: March 7-8, 2016

• Provider Call Center Resumes Full Service
• Routine Chiropractic Services Not Covered Under Blue Medicare Benefits
• Medicare Advantage Providers: Please Review Your Demographic Information With BCBSNC

Important Updates and Reminders:  

• Rx Utilization Management Changes Effective April 1, 2016
• Have you signed up for our convenient EFT service?  Electronic funds transfer (EFT) will become BCBSNC’s standard provider payment method, so sign up today!

Did you know these articles are posted online on the Important News page of our provider Web portal at www.bcbsnc.com/providers?  Please visit the news page and scan through recent and past articles at your convenience.

Have you signed up to receive news and updates from BCBSNC via Provider eBriefs, our e-news service?  If you are not registered, please sign up to begin receiving these timely and important e-communications today.

BCBSNC Updates: January 25, 2016

Blue Cross and Blue Shield of North Carolina (BCBSNC) is committed to informing health care providers and facilities participating in our networks about recent medical policy updates, new products and programs, and other relevant BCBSNC news.

The following links are to articles of interest published on BCBSNC’s provider-specific Important News page . Please share this e-newsletter with others in your office who may benefit from the information and encourage them to sign up to receive it directly.

Release Dates: January 19-22, 2016

• Additional Methods Available for Managing Patient Care Needs
• Be Sure to Include the Entire Member ID Number on Claims

Important Reminders

• What to Do If Your BCBSNC Patient Has Not Yet Received a 2016 ID Card
• Please review the article posted in December about the changes you will now see on ID cards issued to our individual and small group members enrolled on our new technology platform.
• Have you signed up for our convenient EFT service?  Please note that electronic funds transfer (EFT) will become BCBSNC’s standard provider payment method as of March 1, 2016. Sign up today!
• BCBSNC’s contract with Carteret Health Care in Morehead City will end February 1, 2016, for our commercial products, including State Health Plan and the Federal Employee Program.

BCBS Committee Update: December 2015

The following are notes from the most recent meeting with BCBSNC.  If you have specific questions or concerns, please contact a BCBS committee representative to assist you.

Narrow Networks

Narrow network product Blue Value was first introduced in 2013.  Last year, we saw a narrow network, Blue Local, added in the Charlotte market and in 2016 we will see Blue Local in the Triangle market.  These plans are here to stay for now and practices cannot “apply” for participation in these narrow network products, but please see the letter below from our NCMGMA President regarding advocacy surrounding these types of plans:

Good Morning Fellow NCMGMA Members,

I wanted to write to you briefly and let everyone know that NCMGMA, the BCBS Committee, the NC Medical Society and the Advocacy Task Force are heavily involved in these issues and will continue to both monitor the changes in addition to having a seat at the table with the stakeholders surrounding these networks.  As with many issues, much of the work goes on behind the scenes and I can assure you these issues are not taken lightly.  Our committees and task forces are hard at work. 

We posted a great article from Modern Healthcare on the blog yesterday regarding this very topic, I highly recommend the read.  https://ncmgm.wordpress.com/2015/12/01/cms-looks-to-imposing-minimum-standards-to-narrow-provider-networks

Please do not hesitate to reach out to myself, Melissa White (BCBS Chair) or Cameron Cox (Advocacy Chair) with any specific issues.  We are  here to help! 

Respectfully,

Jacob A. Rodman
2015-2016 NCMGMA President
jrodman@raleighneurosurgical.com

TouchCare – Telemedicine

The BCBS investment arm along with Medical Mutual and Fortress Investments are investing in Durham based TouchCare, a telemedicine company.  TouchCare was created in 2013 and aims to connect patients to THEIR healthcare providers in the mobile space.  Practices are using it to provide better access, increase compliance with follow up visits, and to aid in provider to provider calls.

• http://www.touchcare.com/

BCBS Telehealth policy:

• http://www.bcbsnc.com/assets/services/public/pdfs/medicalpolicy/telehealth.pdf

Medical Records

Proactive submission of medical records to support medical necessity is now available as of December 1st.  Please refer to the following link for the services typically requiring medical records and the protocols for submission of proactive records.

• http://www.bcbsnc.com/content/providers/news-and-information/news/Medical_Records_Process_Change_FINAL.htm

Electronic Solutions

Blue Medicare Advantage and Blue Supplement are now merged with Blue E.  You no longer need to use HealthTrio for these lines of business.

Credentialing / Contracting

• Rolled out a new provider information management system.
• Working on a bulk upload enhancement for mass enrollment, terminations and updates.

State Health Plan Overpayments

Affected practices will receive a bar coded invoice containing the overpayments.  You may return a check or choose to have voucher deductions.

• https://www.bcbsnc.com/content/providers/news-and-information/news/SHP_Duplicate_Payments_UPDATE.htm

EFT Requirement

If you are not currently enrolled for EFT payments, please do so before the end of February 2016.

• https://www.bcbsnc.com/assets/providers/public/pdfs/eftrequest-form.pdf