Blue Cross Blue Shield of TX will Manage all Prior Authorizations for HealthSelect, Effective March 1, 2020

There are important changes to the prior authorization requirements for the HealthSelect of Texas and Consumer Directed HealthSelect plans administered by BCBSTX. The list of services requiring prior authorization has not changed; however, beginning March 1, 2020, prior authorizations for services previously managed by eviCore healthcare® will now be managed through BCBSTX.

For more information visit the BCBS file.

Cigna MA PCP E-Newsletter

Topics this month include:

  • American Heart Month
  • Stars Update – HEDIS MRR & HOS
  • CAHPS Corner – CAHPS survey
  • Valuable Insights – Annual Wellness Visits

View this Newsletter in the Cigna HealthSpring file.

Cigna MA Monthly Lunch and Learn Webinars

CareAllies Coding Team will be hosting MONTHLY Lunch and Learn Webinars.

On Friday, March 20th from 12:00 PM -1:00 PM (CT) via WebEx the agenda will be:

• e-cigarette, or vaping, product use associated lung injury (EVALI)
• New IDC-10 code for vape related injury
• What do your members think of you?

To get more details click here.

BCBSTX Opt in/out – oops

In case you do not realize it, POET works hard to get information out to you as quickly as possible. In our rush to get the March 1, 2020 updated fee schedule to you – we left out the “Opt in/out” form!

We are emailing the forms to you today! If you do not receive one please notify us!

BCBSTX Fee Schedule Update

Look for your “Opt-in/out” packet from POET next week. POET has been receiving bits and pieces of the fee schedule this week.

The update is effective March 1, 2020.

Beware Phishing Attempts in 2020

Rachel V. Rose, JD, MBA
January 13, 2020
Health IT, Pearls, Practice Management
According to the National Institute for Standards and Technology (“NIST”), phishing is defined as “[a] technique for attempting to acquire sensitive data, such as bank account numbers, through a fraudulent solicitation in email or on a web site, in which the perpetrator masquerades as a legitimate business or reputable person.” Often times, phishing attacks, especially those executed through email and unsecure websites, lead to the deployment of ransomware.

To view the entire article check out “Security” under the “Compliance” File.

OR

Mandated Use of the Texas Prescription Monitoring Program.

Effective March 1, 2020

Prescribers and pharmacists or their delegates will be required by Texas State Law to use the Texas Prescription  Monitoring Program (PMP) to review a patient’s prescription history BEFORE prescribing or dispensing opioids, benzodiazepines, barbiturates, or carisoprodol. 

You can review the PMP pamphlet here under the Compliance file labeled “Pharmacy” or just click here. 

For additional resources and information about the Texas PMP, please visit txpmp.org.

Provider Directory Updated 1/31/2020

To view the current Provider Directory please follow this link.

Provider Roster Updated 1/31/20

To view the lasted updated Roster click here.

UnitedHealthcare Out-of-Network Referrals: Prior Approval, Patient Consent

By Ellen Terry, An Article by TMA

If you are a UnitedHealthcare (UHC) participating physician referring a patient out of network in a non-emergency, you’re now required to first obtain either (1) prior approval from UHC; or (2) the patient’s written consent.

 

To review the entire article follow this link.