Fraud Alert for Medicare Providers

The Centers for Medicare and Medicaid Services (CMS) and the Investigations Medicare Drug Integrity Contractor (I-MEDIC) have identified a fraudulent fax scheme targeting healthcare providers.

New to Blue Advantage Webinar Coming in October

Blue Advantage will host our New to Blue Advantage provider webinar on Wednesday, Oct. 15.

Antidepressant Medication Management

Information on the HEDIS^® measure regarding the importance of members with a diagnosis of major depression treated with antidepressant medication.

HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA).

Blue Advantage and GLP-1 Agonist Documentation

Blue Advantage will be updating our review process for GLP-1 Agonists.

Use of CPT^® Category II Codes

CPT II codes describe clinical components that may be typically included in evaluation and management (E&M) services or other clinical services and do not have a relative value associated with them.

Blue Advantage Medical Policy Update

We develop and revise medical policies in response to changing medical technology. Benefit determinations are made based on the medical policy in effect at the time of the provision of services. Please review the following medical policies, all of which can be found on our Blue Advantage Resource Page at www.lablue.com/providers, click “Go to BA Resources” at the bottom of the screen, and then the “New/Revised Medicare Advantage Medical Policies” tab.

Important Contact Information

Authorizations (including Case and Medical Management)

1-866-508-7145, choose option 3, then option 3

Behavioral Health

1-866-508-7145, choose option 3, then option 3

Blue Advantage Customer Service

1-866-508-7145 customerservice@blueadvantage.lablue.com

Blue Advantage Provider Portal

1-866-508-7145, choose option 3, then option 2

Provider Credentialing and Data Management

1-800-716-2299, option 2 (provider record information) PCDMstatus@lablue.com

Pharmacy

1-800-935-6103/TTY:711

The Blue Advantage Insight Newsletter is an email-only newsletter designed to keep our Blue Advantage network providers informed and engaged on the latest news and the Centers for Medicare and Medicaid Services (CMS) requirements for our Medicare-eligible members.

The goal of the publication is to help providers and office staff who serve our Blue Advantage members understand how Blue Advantage differs from our other provider networks.

Past Issues of Blue Advantage Insight Newsletter

Visit the Blue Advantage Resources page to view reference materials, forms, past webinar and workshop slides, plus copies of this newsletter. Go to https://providers.lablue.com/ba-resources.

Blue Cross and Blue Shield of Louisiana is an independent licensee of the Blue Cross Blue Shield Association.

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