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Provider Communications Administration Manual

www.bcbst.com

BlueCross BlueShield of Tennessee Provider Administration Manual 11 I. INTRODUCTION BlueCross BlueShield of Tennessee, Inc. is an independent licensee of the BlueCross BlueShield Association consisting of some 60 BlueCross and/or BlueShield Plans throughout the United States.

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Quick Guide to - BlueCross BlueShield of Tennessee

www.bcbst.com

BlueCross BlueShield of Tennessee participates in Medicare Advantage PPO Network Sharing arrangements, and contracted provider reimbursement is based on the contracted rate with BlueCross BlueShield of Tennessee Non-contracted provider reimbursement is the Medicare allowed amount based on where services are rendered.

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Predetermination Request Form - BlueCross …

www.bcbst.com

CPT® is a Registered Trademark of the American Medical Association BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield ...

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Predetermination Request Form - Health Insurance

www.bcbst.com

CPT® is a Registered Trademark of the American Medical Association BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield ...

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Predetermination Request Form - Health Insurance

www.bcbst.com

CPT® is a Registered Trademark of the American Medical Association BlueCross BlueShield of Tennessee, Inc., an Independent Licensee of the BlueCross BlueShield ...

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BlueAdvantage (PPO)SM 2022 Formulary - bcbst-medicare.com

www.bcbst-medicare.com

“us”, or “our,” it means BlueCross BlueShield of Tennessee, Inc. When it refers to “plan” or “our plan,” it means BlueAdvantage. This document includes a list of the drugs (formulary) for our plan which is current as of 02/01/22. For an updated formulary, please contact us. Our contact information, along

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2018 Preferred Formulary Changes - BlueCross

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s. wabs/month Stendra # #8 tablets/month # - Some plans do not cover these medications.Check with BlueCross Member Services to determine coverage at the phone numberlisted on your BlueCross BlueShield of Tennessee member ID card.

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Provider Enrollment Form - Health Insurance

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Provider Enrollment Form-- Confi. dential --Completion and acceptance of this enrollment form by BlueCross BlueShield of Tennessee, Inc. is not a guarantee of network participation.

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Electronic Billing Request - OfficeAlly

www.officeally.com

Note: It is the provider's responsibility to obtain and review all electronic reports to ensure proper receipt of claims by BlueCross BlueShield of Tennessee.

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508C Provider Administration Manual

www.bcbst.com

Reimbursement Policy for Serious Reportable Adverse Events (Never Events) 7. BlueCross BlueShield of Tennessee (BCBST)/BlueCare Tennessee (BCT) Facility Fee Schedule Reimbursement Methodology Policy 8. Hospital Outpatient 9. Hospital Outpatient/Ambulatory Surgery 10. CPT ® Code with Surgery Revenue Code. 11. Observation Room 12.

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508C, Commercial Prior Authorization Form

www.bcbst.com

BlueCross BlueShield of Tennessee, Independent Licensee of the Blue Cross Blue Shield Association. 21PED1143952 (5/21) *Please check benefits to determine group-specific prior authorization requirements. • Hospice • Advanced Therapeutics: - Provider-Administered Specialty Pharmacy Products • Lab Sleep Studies (for 18 years or older)*

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Commercial Remittance Advice Code Descriptions

www.bcbst.com

The electronic remittance advice (ANSI-835) uses HIPAA-compliant remark and adjustment reason codes. Where appropriate, we have included the HIPAA-compliant remark and/or adjustment reason code that corresponds to a BlueCross BlueShield of Tennessee explanation code. Standardized descriptions for the HIPAA adjustment reason and remark codes can ...

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BlueAlert SM - Health Insurance

www.bcbst.com

1 | March 2018 BlueAlert SM MARCH 2018 INSIDE THIS ISSUE BlueCross BlueShield of Tennessee, Inc. Medical Policy Updates/Changes Availity Replaces BlueAccess for Providers

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Commercial Remittance Advice Code Descriptions

www.bcbst.com

The electronic remittance advice (ANSI-835) uses HIPAA-compliant remark and adjustment reason codes. Where appropriate, we have included the HIPAA-compliant remark and/or adjustment reason code that corresponds to a BlueCross BlueShield of Tennessee explanation code. Standardized descriptions for the HIPAA adjustment reason and remark codes can ...

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Bariatric Provider Form.01142018docx - Health Insurance

www.bcbst.com

BlueCross BlueShield of Tennessee Bariatric Surgery Precertification Request Form The BCBST Medical Policy for Bariatric Surgery for Morbid Obesity can be found at

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Total Healthcare Management, Utilization Management and ...

www.bcbst.com

• Related to an authorization? – Fax: (423) 591-9451 BlueCross BlueShield of Tennessee . 1 Cameron Hill Circle, Suite 0017 . Chattanooga, TN 37402-0017

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2022 Pharmacy Directory - bcbst-medicare.com

www.bcbst-medicare.com

“us”, or “our,” it means BlueCross BlueShield of Tennessee. When it refers to “plan” or “our plan,” it means BlueAdvantage. We call the pharmacies on this list our “network pharmacies” because we have made arrangements with them to provide prescription drugs to Plan members. In most cases, your prescriptions are covered under

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BlueCross BlueShield of Tennessee, Inc.

www.bcbst.com

BlueCross BlueShield of Tennessee, Inc. is an Independent Licensee of the BlueCross BlueShield Association January 2016 SM BlueCross BlueShield

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Tennessee 1 Came ron H ill C rcle Chattanooga, TN 374 02 ...

www.bcbst.com

Tennessee 1 Came ron H ill C rcle . Chattanooga, TN 374 02-0001 . ... (HCPCS\) and International Classification of Diseases \(ICD\) Coding ... Reimbursement Policy for Serious Reportable Adverse Events (Never Events) BlueCross BlueShield of Tennessee

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BlueCross BlueShield of Tennessee

www.bcbst.com

72156 MRI Cervical Spine with and without contrast W & W/O 8/1/2006 N/A 72157 MRI Thoracic Spine with and without contrast W & W/O 8/1/2006 N/A 72158 MRI Lumbar Spine with and without contrast W & W/O 8/1/2006 N/A 72159 MR Angiography (MRA) Spinal Canal and contents -with or w

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