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BLUECONNECT
Providers
June 2024
In This Issue
► June news: Executive summary
► New effective date for annual fee schedule update: Aug 15
► August 2024 code edit changes
► Medicare Advantage ID cards now available via Availity portal
► Introducing Prosano Circle
► We’re now using Availity for Medicare Advantage provider resources
Revised: Annual fee schedule updates now effective August 15
We have moved back the effective date for our annual fee updates from July 1 to August 15. We will post the updates on the AZ Blue provider portal by July 15. To preview them, go to “Provider Resources > Guidelines > Claim Pricing.” Then select one of the fee updates links: ASC, Outpatient, Professional, Unclassified Drug, or Per Diem Base Rates. 
This article and our online posting of the updates serve as the advance notice of these fee schedule changes that is required by our provider participation agreements.
Future annual updates
Going forward, we will shift our annual update to July 1 (rather than April 1). For the other routine updates, we will continue on a quarterly schedule (January 1, April 1, and October 1), unless we notify you of a delay.
AZ Blue proprietary fee schedule sources
For commercial plans, we base our fee schedules on a number of sources that may influence the need for changes. These include:
• Medicare fee schedule updates
• Claim information
• Competitive pricing data
• Feedback from AZ Blue network providers 
We modify fees based on ongoing utilization analysis. We also consider market updates such as CMS code changes, pricing for new drugs, price changes for listed drugs, correction of over- or undervalued fees, and other market shifts.
Additional resources
You can access our code edit guidelines and the C3 tool on the AZ Blue provider portal at “Provider Resources > Guidelines > Claim Coding > Code Edit Guidelines and C3 Tool.” We update these resources as needed.
If you have questions, feel free to reach out to your Provider Relations Contact or call Provider Partnerships at 1-800-232-2345, ext. 4231.
In This Issue
► June news: Executive summary
► New effective date for annual fee schedule update: Aug 15
► August 2024 code edit changes (effective July 1)
► Medicare Advantage ID cards now available via Availity portal
► Introducing Prosano Circle
► We’re now using Availity for Medicare Advantage provider resources
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