February 2012

Learn how to verify eligibility, benefits for split contract on MOS
As we move our remaining business to the Michigan Operating System in 2012, many of our customers will offer a Medicare Advantage product to their employees 65 and older.

Contracts with Medicare Advantage coverage only are not moving to MOS. However, we will migrate split contracts that include commercial benefits and Medicare Advantage coverage.... Read more.

Inside this issue for you

• Blues highlight medical, benefit policy changes
• Customize your Record subscription
• Clear Claim Connection^™ to reflect correct coding rules for ClaimsXten^™ processing
• HEDIS medical record reviews begin in February
• Timely processing requires using the correct form

• Learn how to verify eligibility, benefits for split contract on MOS
• Blues highlight medical, benefit policy changes
• Customize your Record subscription

• 2012 benefits change for Delphi hourly members

• Reminder: Patients need to submit CPAP proof of compliance

• HEDIS medical record reviews begin in February
• CMS announces new preventive health screenings
• Medicare Plus Blue PPO^SM covers annual wellness visits
• Bill screening, not diagnostic, codes for mammography, colorectal screenings
• Advanced Illness Program gives education, support to members with terminal illness
• Blues launch Medicare Advantage disease management programs
• Contracted Medicare Advantage providers must follow dispute process for audit appeals
• Blues Medicare Plus Blue PPO^SM plans offer SilverSneakers^® Fitness Program to members

• Opioid quantity limits don't apply to MESSA

• Clear Claim Connection^™ to reflect correct coding rules for ClaimsXten^™ processing
• HEDIS medical record reviews begin in February
• Timely processing requires using the correct form
• Opioid quantity limits don't apply to MESSA

• Vision claims tips article corrected

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2011 American Medical Association. All rights reserved.