Provider News & Updates
Below you will find the latest on important information that may impact your practice, as well as copies of letters and notices we have released.
News and Updates
September 22, 2023
New & Revised Codes for October 1, 2023 (Adaptive Maintenance)
View our recent correspondence to learn about new and revised codes.
September 15, 2023
Reminders on New Online Prior Authorization Portal
The portal is live. View reminders here.
September 12, 2023
NEW Prior Authorization Portal is live today
It is accessible through your existing Provider Resource Center (PRC) username and password.
The Prior Authorization Users Guide and pre-recorded demos are located on Prior Approval Authorization page under the Prior Approval Authorization Resources.
If you have any questions, please contact provider relations by email at providerrelations@bcbsvt.com or phone at (888) 449-0443 option 1.
August 24, 2023
Transcranial Magnetic Stimulation Medical Policy Update for November 1, 2023
View more details here.
August 17, 2023
ClaimsXten-Select™ for November 1, 2023
The ClaimsXten-Select™ upgrade is scheduled for Wednesday, November 1, 2023. Review full details here.
August 13, 2023
New Online Prior Authorization Portal effective September 12, 2023
View more details here.
August 10, 2023
MD RX and HIT Fee Schedule
We are conducting an analysis of our community fee schedules for NDC and HCPCS. The focus is for the categories of administrative, miscellaneous, investigational, radiopharmaceuticals, drugs “administered other than oral method”, chemotherapy drugs, select pathology, laboratory, and temporary codes.
July 27, 2023
RADV Project
We have partnered with Reveleer again this year for the medical record retrieval of 2022 claims identified in the RADV project. Outreach has begun. If you received a request from Reveleer, please be sure to respond promptly following the instructions they provide.
If you have any questions on the RADV project, please contact a member of the Risk Adjustment Department by email at RiskAdjustment@bcbsvt.com or phone at (802) 371-3540.
July 21, 2023
UPDATE: Mailing claims or document to Blue Cross VT
Everything is back to usual. Thank you for your patience while we worked through the issues related to the Montpelier, VT Post Office flooding and closing.
Starting yesterday (July 20, 2023) we are picking up our mail daily at a temporary location. This will continue until the Montpelier, VT Post Office is reopened.
Outgoing mail was not impacted, the Barre, VT Post Office has been assisting us since the closing of the Montpelier, VT Post Office.
Please Note: The Montpelier Post Office notified us a significant amount of mail was lost to the flood. We would recommend anything you mailed into Blue Cross VT from July 5 - July 12, 2023, be resent as it was likely not received by Blue Cross VT.
July 18, 2023
Electronic claim submissions for Vermont Blue Advantage (VBA)
Electronic claims submitted to Blue Cross VT for VBA members (prefixes - V4B and BVT) on Monday (7/10/23) or Tuesday (7/11/23) were misdirected to Blue Cross VT, rather than VBA for processing. The claims have denied through our Blue Cross VT provider voucher with a denial of unable to identify member. We apologize for this error; the issues has been fixed. If you have denied claims, please submit again electronically and they will be routed to VBA for processing.
June 30, 2023
Preventive Care Guide Updates
The following changes have been made to the Preventive Care Guide.
The complete Preventive Care Guide is located here: https://www.bluecrossvt.org/documents/preventive-care-guide.
June 30, 2023
Independent Laboratory Network
NSTX a genetic testing laboratory has been added to our network. The full list of in-network independent laboratories is located here: https://www.bluecrossvt.org/providers/provider-forms-resources under Additional Resources, Laboratory Services.
June 29, 2023
NEHP & ABNE Changes for MD Rx and ABA
There are changes effective September 1, 2023. Find details here.
June 27, 2023
Third Quarter Directory Validation (CAA)
Is occurring the week of July 3, 2023. All providers are required to complete their directory listing by Monday, September 30, 2023.
If you do not meet this deadline, we will immediately remove you from the network directory, and consider terminating your contract.
Please understand that we do not want to take either of these actions. However, it is vital that we comply with our legal obligations.
Details about the CAA Directory Validation and instructions to complete the process are located on the Enrollment and Credentialing area of our website: https://www.bluecrossvt.org/providers/enrollment-and-credentialing; "CAA Directory Validation" section.
June 26, 2023
COVID-19 Related Policies
Are expiring on June 30, 2023. Find details here.
June 22, 2023
Radiology Clinical Appropriateness Guidelines
Effect September 10, 2023 there are changes. Find the details here.
June 19, 2023
New & Revised Codes for July 1, 2023 (Adaptive Maintenance)
View our recent correspondence to learn about new and revised codes.
June 8, 2023
CME/CE Course Options
Take advantage of a free CME/CE course bundle from the American College of Lifestyle Medicine. The courses provide a foundational, evidence-based introduction to the field of lifestyle medicine with a focus on nutrition, often the most complex behavior to change, to prevent, treat and reverse chronic disease.
June 5, 2023
Acuity Connect
Is back up and fully functional. If you encounter any issues, please contact provider relations at providerrelations@bcbsvt.com or phone at (888) 449--443, option1.
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09-22-23: New & Revised codes for October 1, 2023 (Adaptive Maintenance)
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09-15-23: Reminders on New Online Prior Authorization Portal
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08-24-23: Transcranial Magnetic Stimulation Medical Policy Update for November 1, 2023
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08-17-23: ClaimsXten-Select™ for November 1, 2023
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08-13-23: New Online Prior Authorization Portal effective September 12, 2023
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08-10-23: MD Rx and HIT Fee Schedule review for November 1, 2023
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06-29-23: NEHP & ABNE changes for MD Rx and ABA effective September 2, 2023
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06-22-23: September 10, 2023 changes to Radiology Clinical Appropriateness Guidelines
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06-19-23: New & Revised Codes for July 1, 2023 (Adaptive Maintenance)
Provider Handbook
Access our Provider Handbook for a comprehensive reference of resources and requirements for Blue Cross providers.
Academic Detailing and Prescription Support for Vermont Blue Rx
Our Clinical Pharmacist, Amy Stoll, PharmD, works with our providers on specific prescription questions, drug authorizations, and patient panel projects. Amy is a board-certified ambulatory care pharmacist, certified diabetes educator and has a master's degree in public health. Learn more about the services our team can provide to you.