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Special Notice

Thomas/Love Class Action Lawsuit

  • http://www.bcbsphysiciansettlement.com/ 
    Website information for Class Members about the Settlement with the Blue Cross and Blue Shield Association and certain Blue Cross and Blue Shield Plans and certain current and former subsidiaries and affiliates in the class action lawsuit known as Love, et al. v. Blue Cross and Blue Shield Association, et al.

  • External Review of Billing Disputes
    Effective November 21, after physicians or physician groups have exhausted our internal dispute resolution processes under the provider contract, they may submit a billing dispute through MES Solutions, an independent company contracted by us to act as an external billing dispute reviewer. This process is only available to physicians and physician groups, and applies only to disputes regarding the application of coding and payment rules and methodologies. The decision of the external reviewer is binding on both the health plan and the physician.

Providers can stay informed of our news via two publications:

Network News
Network News is a quarterly newsletter for our network providers. Every issue contains Medical Policy Updates and information and tips on changes to processes, such as claims filing procedures or reimbursement changes, along with a number of featured articles.

Latest Issue

  • 3rd Quarter 2009 [PDF]
    Featured topics: BDC for Cardiac Care, Updated Provider Manuals, CLIA Registration Required, Freestanding Diagnostic Imaging Credentialing Requirements, TRICARE Bid Results, Time to Report Your Office Hours, Your Provider Relations Rep,  Serious Preventable Events Policy, POA Indicator Required on Facility Claims, Billing Guidelines for Prolonged Services, Influenza Vaccine Billing Guidelines, What is Mental Health Parity?, Facets Change for Facilities, Change in Licensee for Puerto Rico, Overpayments for Out-of-State Claims, Medicare Advantage, BlueCard Member Claims Tips, BlueCard Appeal Tips, iLinkBLUE Sticky Notes, Blue Cross’ Valuable Electronic Services, Online Provider Directories Offer More, Chlamydia Screenings, CTA Scanner Information Needed, Blue Cross Has a Pandemic Plan, AIM’s New Interactive Safety Tool, Medical Policy Update, Auths Required for Targeted Medications, First Fill for Free, Lead with Generics, CDC Hurricane Health & Safety Tips, The Success of Our Imaging Authorizations Program, 2009 Angel Award Winners Selected and more...

More News

Blue News
Blue News is a quarterly newsletter e-mailed to hospital administrators covering topics of special interest to hospitals.  

Latest Issue

  • August 2009 [PDF]
    Featured topics: Healthcare Reform, Serious Preventable Events, POA Indicators, Health Plan Administrative Costs, Blue Distinction Centers, Healthcare Trends in America, Referring Physician NPIs, TRICARE Update, Outpatient Codes and Facility Manual Updates, and Blue Cross Electronic Services.

    *You must have Adobe Acrobat Reader Version 8 or later to view.

Read other Blue News

To search for a specific topic in Network News or Blue News, enter key words on the search page.

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