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BLUECONNECT
Providers
November 2023
In This Issue
► November news: Executive summary
► Important information about our 2024 HMO plans
► Register for a lifestyle medicine course at no cost
► Help increase the use of preferred biosimilar drugs
► Overview of diabetes measures for MY 2023
► AZ Blue fee schedule updates
Our Gold Card program makes prior auth easy for qualifying providers: Learn more!
November news: Executive summary
Thanksgiving message from AZ Blue CMO Dr. Cara Christ
On behalf of our entire AZ Blue Clinical Excellence team, I want to extend my sincere gratitude for everything you do to care for our members at all stages of life and health. We appreciate your partnership in making quality healthcare available and affordable across Arizona.   
Updates for your teams
  Reminder! Expanded use of MCG care guidelines started November 1 
On November 1, 2023, Blue Cross® Blue Shield® of Arizona (AZ Blue) began using MCG instead of InterQual® for commercial plans. Learn more.
Check out these 2024 product offerings
• ACA StandardHealth plan with the ACA Health Choice network – Introduction
• Affordable Care Act (ACA) plans and networks – Overview
• Medicare Advantage plans and networks – Overview
• Prosano plans and networks – Overview
  Make a difference by taking the Stigma-Free Arizona pledge
Please invite your teams to join us in reducing stigma around behavioral health care. Visit the Pledge page. 
Want to participate in our Gold Card prior authorization program? 
Find out how to qualify and how the program can save you time. Visit our Gold Card information webpage.  
PCP referrals to specialists: AZ Blue approval no longer required
For PCP-HMO plans, we no longer require AZ Blue approval for PCP referrals. In-network referrals are still required for specialist office visits and the referral information should be included on the claim. If the patient needs care from an out-of-network specialist, you must request prior authorization to ensure coverage.
Grants available from ADHS to integrate behavioral health into primary care practices
With the goal of integrating behavioral health care into primary care settings, the ADHS Bureau of Women’s and Children’s Health (BWCH) administers the Collaborative Care Uptake Fund Program. This program supports primary care providers and technical assistance centers to implement evidence-based Collaborative Care Models (CoCM). Grants are now available for:
1. PCP practices with 50 or less employees, to meet initial costs of establishing and delivering behavioral health integration services through the CoCM: SEE DETAILS AND APPLY
2. Technical Assistance Centers, established to provide technical assistance to PCPs in providing services through the CoCM: SEE DETAILS AND APPLY
CEU opportunities (at no cost)
1. Join us for the December 6 Arizona Community Grand Rounds session Emerging Infectious Disease: What’s Ahead in Arizona. We’ll hear from Dr. David Engelthaler, Director of Pathogen Genomics, TGen North, and Dr. Lisa Villarroel, CMO, Arizona Department of Health Services. They’ll share recent trends in Arizona pathogen surveillance and the latest public health information about infectious illnesses. We’ll also discuss opportunities for enhanced information sharing to track emerging pathogens in the state. REGISTER NOW. 
2. Take advantage of this complimentary American College of Lifestyle Medicine (ACLM) course (5.5 CME/CE credits) to learn how to help patients modify lifestyle behaviors as a way to prevent, treat, and even reverse the progression of chronic disease. See how ACLM makes something so challenging actionable for your patients. 
3. December 5: As part of the 2023 ACEs & Resilience Summit, the Center for Resiliency & Wellbeing is offering a virtual training with presenters from across the country on topics related to The Whole Child: Nurturing Health & Wellbeing through Relationship & Resiliency. Learn more and REGISTER (8 CME credits).
4. Still available: Mountain ECHO Academy, for virtual “all-teach, all-learn” educational sessions held on the first, second, and third Monday of the month, through May 2024. Mountain ECHO programs offer one CEU per session.
Substance Use Disorders – first Mondays, noon-1 p.m.
Trauma in Children – second Mondays, noon-1 p.m.
Social Determinants of Health – third Mondays, noon-1 p.m.
REGISTER at Mountain ECHO – BCBSAZ Health Choice (healthchoiceaz.com).
5. For behavioral health providers: The American Diabetes Association® is offering CEU opportunities for behavioral health providers who work with patients living with or at high risk for diabetes. Learn more and REGISTER NOW.    
Secure azblue portal tips
• Checking eligibility and benefits: Be sure the member ID prefix used in your inquiry is valid for the date of service. Alternatively, you can use the “Name” search option. For more information about our 2023 prefix replacements for certain members, visit the azblue.com/prefix page.
• Accessing online remits: You can now search remits by Check/EFT Number. Also, using a narrow date range (within the same calendar year) can optimize your search results. 
For more information about these updates, contact us at 602-864-4231 or 1-800-232-2345, ext. 4231, or reach out to your Provider Relations Contact. 
In This Issue
► November news: Executive summary
► Important information about our 2024 HMO plans
► Register for a lifestyle medicine course at no cost
► Help increase the use of preferred biosimilar drugs
► Overview of diabetes measures for MY 2023
► AZ Blue fee schedule updates
Our Gold Card program makes prior auth easy
for qualifying providers: Learn more!
The MCG care guidelines are the proprietary and copyright-protected information of MCG Health, part of the Hearst Health network. 

InterQual is a registered trademark, and InterQual criteria are the proprietary and copyright-protected information, of Change Healthcare LLC (part of Optum) and/or one of its subsidiaries.

American Diabetes Association is a trademark of American Diabetes Association, Inc.

Blue Cross, Blue Shield, the Cross and Shield Symbols, MyBlue, BlueCard, Federal Employee Program, and FEP are registered service marks, and BluePathway and BlueJourney are service marks, of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.

© 2023 Blue Cross Blue Shield of Arizona, Inc. All rights reserved.


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