Get ready for 2027: Join our upcoming provider training sessions

As Blue Cross Blue Shield of North Dakota (BCBSND) commercial and BlueCard® Host members begin migrating to new systems starting Jan. 1, 2027, providers may need to navigate different policies, processes and workflows based on a member's migration status.

To help your practice prepare, BCBSND is offering a series of trainings on the operational and administrative changes you may encounter throughout 2027. These virtual sessions include moderated Q&A and practical guidance to help your team confidently manage the transition.

These sessions provide valuable information, resources and tools to help reduce disruptions and support a smooth transition for your staff and patients. The training series also highlights how to use the Provider Support Hub as your central source for migration-related updates and resources.

Website navigation, tools and system

This Monday, we held our first training session. This webinar introduced the phased member migration that will impact your practice beginning Jan. 1, 2027. Topics included:

• Understanding migrated and non-migrated member populations
• Identifying new member ID cards and migration status
• What is changing and what is staying the same
• How migration status affects policies, prior authorization, appeals and administrative requirements
• Updates to website navigation, policy searches and provider tools
• Resources available through the Provider Support Hub, HealthCare News and Availity Essentials
• Best practices for determining the correct member path and requirements

Recordings of previous sessions, including the Oct. 12 training, will be available through the Provider Support Hub.

Upcoming training sessions

Virtual Teams sessions | Mondays | Noon to 1 p.m. CT | Moderated Q&A

Oct. 19: Coding and Reimbursement Resources

Learn how member migration may affect coding reviews, claims edits and reimbursement processes. Topics include:

• Expanded coding validation and reimbursement edits for migrated members
• Using the Coding Toolkit to identify billing, modifier and documentation requirements
• Reimbursement policy searches and audience-specific policy tagging
• Tips to help reduce claim denials, payment delays and unnecessary rework

This session is especially valuable for coding, billing and reimbursement staff.

Oct. 26: Medical Policies, Appeals and Prior Authorization

Understand how medical policies, prior authorization requirements and appeals processes may differ for migrated and non-migrated members. You'll learn:

• How to identify which policies and workflows apply to a member
• Prior authorization requirements and resources (Note: To learn about new prior authorization requirements for certain spine and joint procedures, please register for the Nov. 16 Physical Medicine webinar included below.)
• New tools and resources to simplify the prior authorization process
• Appeals processes and supporting documentation requirements
• Where to find the latest guidance and policy updates

If your practice regularly manages authorizations or appeals, this session can help you prepare for upcoming changes.

Nov. 2: Claims Processes and Updates

Gain a deeper understanding of claims submission and payment changes that may impact your organization, including:

• Claims submission requirements and processing updates
• New coding and reimbursement review processes
• Fragmented billing requirements
• Claim offsets, overpayment recovery and coordination of benefits updates
• Electronic funds transfer (EFT) information

This session is recommended for billing managers, revenue cycle teams and practice administrators.

Nov. 9: Pharmacy Updates

Explore upcoming pharmacy-related changes and new tools designed to support providers and patients, including:

• Real-time pharmacy benefit check tools integrated within your EMR
• 2027 drug formularies and quantity limits
• Pharmacy prior authorization resources
• Medical and retail benefit drug policy updates

Providers, prescribers and pharmacy staff will gain practical insights to help improve medication access and support patient adherence.

Nov. 16: Physical Medicine Program for Spine and Joint Management

Prepare your practice for new prior authorization requirements for certain spine and joint procedures beginning Jan. 1, 2027. Topics include:

• Services subject to the new Physical Medicine Program
• Prior authorization requirements and timelines
• How to submit and track authorization requests
• Navigating the EviCore and Availity Essentials portals
• Clinical review processes and authorization outcomes
• Additional documentation, urgent requests and special circumstances
• Reconsideration, peer-to-peer consultation and appeal options
• Provider resources, support tools and training opportunities available through EviCore and BCBSND

We look forward to connecting with you.