Quarterly Provider Insights, December 2023

Quarterly Provider Insights shares information to our provider community in the third month of each quarter.

Quarterly Provider Insights will provide information regarding a company message, news and announcements, educational topics and miscellaneous updates.

Top Articles this Quarter 

Doctor taking medical insurance card from patient

Medicaid Expansion Claim Submission- Medicaid ID Notification- Update

After further review and collaboration with the Department of Health and Human Services (DHHS), it has been decided not to move forward with this implementation. There will be no front-end rejections for Medicaid Expansion 837P or 837I claim(s) submitted without the provider Medicaid ID number at this time.

woman at a pharmacy turning in a prescription

Pharmacy Formulary Changes Effective Jan. 1, 2024

Effective Jan. 1, 2024, Blue Cross Blue Shield of North Dakota (BCBSND) is making the following changes to the BCBSND Formulary, NetResults Formulary, and Health Insurance Marketplace Individual Small Group 4 tier and 6 tier Formularies.

Mature female patient undergoing for CT scan examination in the hospital.

Urgent Notice Regarding Positron Emission Tomography (PET) Scanning

Effective 12/15/2023, BCBSND will move this service from a pre-service review to a post-service review. By moving this to a post-service claim review, it will allow providers to move forward with their treatment plan without waiting for a response from pre-service review.

HealthCare News Weekly

Provider HealthCare News (HCN) Weekly articles are used to communicate timely provider information including policy, benefits, coding or billing updates, education, and more to our provider community through email/eBlasts for providers who have registered to receive HCN articles weekly. Sign up to receive HCN weekly.