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What's New
Availity Participating Provider Training Webinars - September 2010
NPI-related Errors to Result in Electronic Claim Rejection as of Sept 6, 2010
Pharmacy Updates - August 2010
EFT ERA EPS: Beyond the Basics, Part 2
2010/2011 Synagis Process
Electronic Refund Management (eRM) - September Webinars
Behavioral Health Program Changes Eff 01/2011 FAQs
IVR Claim Status Menu Changes in July
Overpayment Reconciliations Simplified
EFT ERA EPS: Beyond the Basics, Part 1
Hospital Acquired Conditions and Never Events
Surgical Procedures Performed in the Physician's/Professional Provider's Office
BCBSTX Offers New Solution for Credentialing
CareCost Estimator (CCE)
Untimed Billing Procedure CPT Codes - Update

Disclosure Notices
Quarterly Drug Updates Eff 12/01/10
Behavioral Health Program Changes Eff 01/2011
Hospital and ASC Updates
Code Auditing & Modifier 59 Exempt Auditing - Update
Ancillary Fee Schedule Update
Professional Fee Schedule Update
Multiple Surgery Pricing Per Session Methodology - Update
 

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  		• Availity L.L.C.
     

        • Free Electronic Health
          Record Via Availity
          CareProfile
     

        • September 2010
          Webinars
  		• eCare/NDAS Online
  		• EDI Format Specifications
  		• EDI Transactions
  		• EFT/ERA Forms
  		• Electronic Funds Transfer (EFT)/Electronic Remittance Advice (ERA)
  		• Electronic Provider Tools Reference Guide
  		• Electronic Refund Management (eRM)
     

        • Webinars
     

        • Overpayment        Reconciliations        Simplified
  		• HIPAA
  		• iEXCHANGEŽ Web -
    Automated Precertification
    and Referral System
     

        • Getting Set-Up with
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        • Web Reference Guide
            • Web Tip Sheet
  		• Online Transaction Tip Sheets
            • Eligibility & Benefits
            • CareCost Estimator       (Member Liability Tool)       via Availity
            • Enhanced Claim Status       (Claims Research Tool)       via Availity
            • CareProfile® via Availity
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        • Evidence Based       Measures & Bridges       to ExcellenceŽ
     

        • Physician Cost       Assessment
  		• Bridges to Excellence
  		• Claim Appeal/ Reconsideration Review Process & Billing Dispute External Review Process (BDERP)
  		• Claim Pointers
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  		• FAQs
  		• Hospital Acquired Conditions and Never Events
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  		• National Provider Identifier
  		• Non-Contracting Providers Requesting Allowables
  		• Physician Advisory Committee (PAC)
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    • Time to be Blue
  		• Provider Manuals Requires password for access
  		• Reference Guides
  		• Special Investigations Tutorial
  		• Wellness Initiatives/Programs
    General Reimbursement Information

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  		• Recoupment/Refund Requires password for access
     
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  		• Significant Edits Requires password for access
     
  		• ...and more... Requires password for access

    Medical Policy

  • Draft Medical Policies

  • Active/Pending Medical Policies

     
  		• Medical Policy Medical Records Documentation Guidelines (Predeterminations/Claims)

    Credentialing/
    Contracting
  		• Physician/Professional Provider
    • How to Join BCBSTX    Provider Networks
    • Credentialing Updates
    • Recredentialing
    • TRICARE - El Paso Only
         • Areas of Interest
  		• Facility/Ancillary
    • Consent to
       Assignment of
       Provider Contracts
       (Change of
       Ownership-CHOW)
    • TRICARE - El Paso Only
         • Areas of Interest

    UM/QI/Medical Management

  • Behavioral Health Medical Necessity Criteria
  		• Clinical Practice and Behavioral Health Guidelines
  		• Clotting Factor Product Initiative
  		• eCards for Health
  		• iEXCHANGE® - Automated Precertification and Referral System
  		• Maternity Program: A Healthy Start for Mothers and Babies
  		• Postpartum Depression - The “Andrea Yates Bill”
  		• Radiology Quality Initiative/Preauth Prgm
  		• Step Therapy Guidelines for City of Houston (COH)
     
  		• Wellness Guidelines
    		 
    Pharmacy
  		• Digitek Recall
  		• Medicare Part D Pharmacy Updates
  		• Medicine Safety Project
  		• Override Request (pdf - 18k)
  		• Preferred Drug Guide
  		• Quantity vs. Time
  		• Specialty Drug Programs
    • Factor Drugs (Accredo)
    • Lowe's (Care Continuum)
    • Lupron (TAP Pharmacy   Solutions)
    • Triessent
         • Split Fill Oral Oncology        Meds
  		• Step Therapy/Prior Authorization
  		• Synagis & RSV
  		• Topical Verapamil

    Provider
    Tools/Programs
  		• Be Smart. Be Well.TM
    • Childhood Obesity
    • Caregiving
    • Domestic Violence
    • Drug Safety
    • Managing Pregnancy Risks
    • Mental Health
    • Sexually Transmitted    Disease (STD)
    • Traumatic Brain Injury    (TBI)
  		• Blue Distinction
  		• Care Comparison® Tool
  		• Obesity Management Tool Kit Web Site


     
     
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