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Hot Topic Library - 2016

The following news items were posted on the PRC on the dates noted. News items are featured on the main page for a minimum of five days and, upon their initial posting date, also are added to this Library. Despite eventually being removed from the main page, the messages may remain relevant and will be maintained here for your future reference.

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Date Posted Provider type Message
12/28/16 All Four Chemotherapy Codes To Be Added To The List Of Procedures Requiring Authorization, Effective March 1, 2017
12/08/16 All Additional HCPCS Codes Do Not Require Submission Of NDC
12/08/16 All Laboratory Management Program Changes Effective Jan. 1, 2017, and Feb. 6, 2017
11/30/16 All Changes To The Highmark Drug Formularies
11/30/16 All Effective 1/1/17, Surgical Procedure Claims With Unlisted Codes Will Require Additional Reports
11/23/16 All Highmark’s Medical Management & Policy Holiday Schedule
11/18/16 All Provider News Issue 5 is Now Available
11/10/16 All CDC Stresses The Importance Of Appropriate Use Of Antibiotics
11/01/16 All Prior Authorization For Non-Emergent Ambulance Transport For Medicare Advantage Members, Effective Jan. 1, 2017
10/31/16 Professional New Essential Formuary
10/07/16 All Reminder: Anesthesia Reimbursement Change Effective Oct. 15, 2016
10/04/16 All Clinical Quality Feedback Now Open for WVFH
10/04/16 All Reminder: Effective 10/14/2016 Clarification Of Prescription Drug Coverage For Select Convenience Kit Products
09/30/16 All Changes to Radiology Management Program Effective 10/3/16
09/27/16 All Provider News Issue 4 is Now Available
09/13/16 All Quicklinks Function Now Available
09/12/16 All Highmark West Virginia Names Cathy Golden As Director Of Provider Relations
09/08/16 All Diabetic Retinal Exam Completed in 2015 - New Report Now Available
09/01/16 All 3rd Quarter Changes To The Highmark Medicare Part D Drug Formularies
09/01/16 All One Drug Being Removed From Highmark West Virginia's Medical Injectable Drug Program
08/25/16 All Highmark West Virginia Announces Adjustments To Select Imaging Fees
08/22/16 All Provider News Issue 3 is Now Available
08/19/16 All Monday, Aug. 29, 2016: New Pharmacy Policy Search Tool Available
08/15/16 All Effective 10/14/2016 Clarification Of Prescription Drug Coverage For Select Convenience Kit Products
08/15/16 Professional Anesthesia Reimbursement Change Effective Oct. 15, 2016
08/09/16 All Reminder: Cover Sheets For UDC Forms Not Needed
08/03/16 All Radiology Management Program Updates: Changes Effective 10/3/2016
08/01/16 All Upcoming Lab Management Program Web Orientation Sessions Aug. 17 And 19
07/26/16 All Next UDC Program "5 IN 5" Live Q&A Series To Be Held Wednesday, July 27 At Noon
07/21/16 Professional Reimbursement Policies to Debut on Provider Resource Center on Aug. 1, 2016
07/12/16 All Medication Reconciliation Post Discharge Incentive - FAQs
07/11/16 All Laboratory Management Program Resources Now Available
06/28/16 All 2016 West Virginia Family Health Primary Care Incentive Program
06/27/16 All eviCore Lab Management Program Prior Authorization Date Change
06/23/16 All Attention: PCPs Monthly Reports Now Available For the UDC Program
06/21/16 All Authorization Requirements Removed From Certain 'C' Codes
06/21/16 Professional Myriad Genetic Laboratories Will No Longer be in the Highmark West Virginia Networks as of Jan. 1, 2017
06/20/16 Professional Final Fourth Quarter Payments for 2015 Unconfirmed Diagnosis Code Program Released
06/17/16 All Documentation Only Update to the 2016 Medicare Advantage Stars Clinical Measures Presentation
06/14/16 All Multiple Surgical Pricing Reductions to be applied to Routine Surgical Procedures
06/14/16 All Medication Reconciliation Post Discharge Incentive
06/09/16 All Updates to eviCore Lab Management Program
06/03/16 All Update On Long Telephone And Fax Wait Times
05/25/16 All Credentialing Process Change for Professional Providers
05/23/16 All Issue 1, 2016 of the West Virginia Provider News is Now Available
05/20/16 All DMEPOS Quality Program Compliance Submission Period Approaching
05/20/16 All 2nd Qtr. 2016 Formulary Update Changes to the Highmark Medicare-Approved Drug Formularies
05/18/16 All Monthly Progress Report Available for the Unconfirmed Diagnosis Code(UDC)Program
05/11/16 All 2016 House Call Program Launches
04/29/16 All Highmark Implementing Lab Management Program July 1, 2016
04/26/16 All Authorization Request Update: Highmark Addressing Long Telephone and Fax Wait times
04/11/16 All 2016 West Virginia Family Health Primary Care Incentive Program
04/01/16 All New Requirements For Highmark's DMEPOS Quality Program For Positive Airway Pressure (PAP) Providers
04/01/16 All Unconfirmed Diagnosis Code (UDC) Program To Launch April 1
03/29/16 All 321 Codes To Be Deleted From The List Of Procedures Requiring Authorization, Effective 4/1/16
03/24/16 All Medical Policy Link Problem On Provider Resource Center
03/24/16 All Updated Locum Tenens Form Is Now Available
03/21/16 All Effective May 1, 2016, Highmark West Virginia To Adjust Fees For ACA Individual Products
03/21/16 All Clarification on Compliance Concern for Annual Wellness Visit and Preventive Physical Exam during the Same Visit
03/21/16 All Reminder: Navinet Is The Preferred Method Of Obtaining Authorizations
03/18/16 All New Authorization Request Fax Sheets Available On Provider Resource Center
03/17/16 All 2016 Medicare Advantage Stars Primary Care Incentive Program Update
03/07/16 All Less HCPCS Codes Require NDC Submission
02/26/16 All Highmark's Self-Service Tools: Easy & Efficient
02/18/16 All 1st Qtr. 2016 Formulary Update Changes to the Highmark Medicare-Approved Drug Formularies
02/17/16 All Issue 6, 2015 of the Highmark West Virginia Provider News is now Available
02/09/16 All APC Pricing Component Calendar Revised
02/05/16 All Introducing New Provider Manuals for All Highmark West Virginia Particpating Providers
02/04/16 All NDC Policy Changes
02/04/16 All Seventeen Codes to be Added to List of Procedures Requiring Authorization, Effective 4/1/16
02/02/16 All Updated: New Provider Training Webinars
01/28/16 Professional 2016 Medicare Advantage Incentive Program Teleconference Sessions
01/19/16 All Second Video Available On Managing High-Risk Medications In The Elderly
01/15/16 All New Provider Training Webinars (Updated on 2/2/16)
01/08/16 All Sixty-Seven Codes to be Deleted From List of Procedures Requiring Authorization, Effective 1/1/16
01/04/16 All Updated List Of Procedures/DME Requiring Authorization, Effective Jan. 1, 2016

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Last updated on 6/15/2017 12:20:24 PM

 

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The following entities, which serve the noted regions, are independent licensees of the Blue Cross Blue Shield Association: Western and Northeastern PA: Highmark Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Choice Company, Highmark Health Insurance Company, Highmark Coverage Advantage Inc., Highmark Benefits Group Inc., First Priority Health, First Priority Life or Highmark Senior Health Company. Central and Southeastern PA: Highmark Inc. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc., Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company. Delaware: Highmark BCBSD Inc. d/b/a Highmark Blue Cross Blue Shield. West Virginia: Highmark West Virginia Inc. d/b/a Highmark Blue Cross Blue Shield, Highmark Health Insurance Company or Highmark Senior Solutions Company. Western NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Cross Blue Shield. Northeastern NY: Highmark Western and Northeastern New York Inc. d/b/a Highmark Blue Shield.

All references to “Highmark” in this document are references to the Highmark company that is providing the member’s health benefits or health benefit administration and/or to one or more of its affiliated Blue companies.