May 2025 Blue Advantage Provider Newsletter

Our Quality Blue Condition Assessment Program is Launching

Our new Quality Blue – Condition Assessment Program (CAP) is rolling out in 2025. With QB-CAP, Blue Advantage providers treating our members can earn additional payments for completing Annual Wellness Visits and accurately and comprehensively assessing conditions.

May is Arthritis Awareness Month

May is Arthritis Awareness Month, a time to recognize the impact of arthritis on quality of life, especially in our aging population. Osteoarthritis (OA), the most common form, affects more than 50% of adults age 65 and older. It often leads to chronic pain, reduced mobility and functional decline. It is critical that we align our care strategies with current clinical guidelines while also promoting safe and effective pain management.

Blue Advantage Medical Records Requests

Blue Advantage partners with Cognisight to assist in conducting medical record reviews.

Who Do I Contact if I have Questions?

For claims status, member eligibility, benefit verification and care management inquires that cannot be resolved through the Blue Advantage Provider Portal, contact Blue Advantage Customer Service at 1-866-508-7145. For questions specific to the Blue Advantage quality program, contact your Provider Relations representative or send an email to provider.relations@lablue.com.

Blue Advantage Medical Policies

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.

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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