All Other Providers

Last Updated on January 20, 2021
Please refer to this section for helpful information about treating Commercial, Medicare Advantage and BlueCare Plus members during the COVID-19 state of emergency.

UPDATED A Message from Todd Ray


Dear Valued Provider,

Now that we’ve moved into a new year, we want to reinforce how grateful we are for our relationship with you and the care you provide to our members. We realize our struggles from 2020 aren’t over yet. But we’re also encouraged by the recent availability of COVID-19 vaccines and the ongoing rollout across our state.

As governmental and operational guidelines continue to shift, we understand that you and your patients have a lot of questions. We’re doing our best to answer them in our FAQs, so please continue to visit this website for important updates. You’ll find information about our COVID-19 policies, as well as the latest information about vaccine policies and procedures.

Also, please continue to check our payer space at Availity.com for updates throughout this state of emergency.

As always, please reach out to your Provider Network Manager if you have questions or need assistance.

Sincerely,

Todd Ray, Senior Vice President, Corporate Provider Network Management and Medicare Products

Important Provider Updates and Resources from Federal and State Governments

  • Read more about the State of Tennessee’s response to the disease on the Tennessee Department of Health website.
  • Click here for the latest information from the Centers for Disease Control and Prevention (CDC).
  • For more general information about coronavirus resources available to the public, you may also call the Tennessee Coronavirus Public Information Line at 1-877-857-2945.

We’re Here To Support You

With surges of COVID-19 cases, we want to help you continue your focus on providing care to our members. This isn’t a comprehensive list of BlueCross actions we’ve taken to help (such as encouraging our members to schedule telehealth visits and the community-serving efforts of our foundation), but rather items we know are relevant to hospital operations:

  • We’ve created a streamlined prior-authorization process for commercial members with a COVID-19 diagnosis admitted through the emergency department. In these cases, we won’t require supplemental clinical information for prior authorizations. This waiver will be in effect through March 31, 2021. We reserve the right to audit after the pandemic, if necessary.
  • We’ve waived prior-authorization requirements for all levels of post-acute care and transfers, as we did in April. This waiver is in effect through March 31, 2021, at which time we’ll reevaluate the policy. As before, we request notification within 24 hours, or one business day, following any related facility transfers in order for our clinical staff to assist our members and their families, and to meet our contractual obligations with plan sponsors.
  • We support the “hospital at home” program included in Governor Bill Lee’s Executive Order 68. We’ll work with any hospital that has met the CMS criteria to implement the program.
  • We’re allowing flexibility to charge inpatient rates in the emergency department or other units where patients may need to be housed, based on intensity of service.
  • We’ve reduced the burden of credentialing during this difficult time. While it’s critical we have accurate rosters of providers to load into our claims system to expedite payments, BlueCross is adhering to Executive Orders and NCQA guidance related to licensure, extending time for re-credentialing, relaxing EFT requirements, providing for expedited credentialing and enrollment, and where necessary, willing to accept the bare minimum information required from hospitals to ensure member safety (i.e., current license and NPDB report).

COVID-19 Emergency Disclaimer

During the COVID-19 emergency, we’ll continue to follow the COVID-19-related policies and processes listed in this section of the BCBSTupdates website. Many of our decisions are guided by federal and state mandates, which occur frequently, so we encourage you to refer to this site daily. Should we decide to make a non-mandated change to a policy or process listed in the provider Q&As during the COVID-19 emergency, we’ll post the update 30 days in advance on this site.


For Commercial, Medicare Advantage and BlueCare Plus lines of business unless stated otherwise.


 

COVID-19 Vaccine

 

COVID-19 Testing and Treatment

 

COVID-19 Drive-Through Testing

 

COVID-19 Antibody Tests

 

Telehealth Coverage

 

Contracting, Credentialing and Enrollment

 

Operations

 

Procedural

 

Your Health

 

Protecting Yourself and Others

 

BlueCross Working for You