2010 BCN PRP Noncompliant Policy Updates
Blue Care Network is offering a Noncompliant Member Policy for the 2010 Performance
Recognition Program. The policy is the same as last year. The 2010 Noncompliant
Member Policy and the form providers must use to return noncompliant member information
to BCN are attached. Please be aware of the following requirements:
1. BCN will pay a flat amount of $20 per member for noncompliant members who meet
the noncompliant conditions that are listed in the attached policy. We will not
give credit in the numerator of the 2010 base PRP score.
2. This policy is for base PRP services only.
3. Providers or provider office staff must complete two steps in order to earn the
$20 payment:
3a. Fax all appropriate documentation to BCN Provider Affairs. You can save
the attached 2009 Noncompliant Member Information Fax Form to your hard drive, type
into it and print it for faxing.
3b. Enter the service for the member in Health e-BlueSM.
4. BCN will accept documentation or entry into Health e-Blue beginning October 1,
2010, but not prior to that date.
See Forms in Documents drop down above.
Important
Changes for the 2010 eRx Incentive Program
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This fact sheet below contains information
about changes to the Electronic Prescribing Incentive Program (eRx) for 2010 as
authorized by the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA).
A web page dedicated to providing all the latest news on the eRx Incentive Program
is available at http://www.cms.hhs.govlERxlncentive
on the Centers for Medicare
& Medicaid Services (CMS) website.
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Click Here
for Fact Sheet
Referral
and Authorization Requests
Please be aware that all referral and authorization requests
for patients assigned to a Greater Macomb PHO primary care physician must be submitted
directly to the patient’s health plan or insurance carrier. Greater Macomb
PHO has elected to allow you to work directly with the health plans and insurance
carriers to obtain referrals and authorizations in order to streamline your office
efficiencies.
Important
information about BCN Advantage Healthy Advantage Rewards member incentive program:
Blue Cross
Blue Shield of Michigan T Codes Updates