We paid for COVID testing prior to inpatient admission separately, even if within the 72-hour window where it would normally be included in the DRG.Until the national PHE ended on May 11, we reviewed requests on a case-by-case basis and made accommodations as appropriate.
#Blue shield timely filing limit 2020 manual#
Hospitals could request an extension for medical record audits and audits for inpatient and outpatient facility claims, manual collection of medical records for HEDIS, and in-office reviews for Quality and Value-based programs due to staffing shortages, overwhelmed hospital capacity or other factors.If a hospital requested an extension for BlueCare appeals time frames past 180 days, we approved reasonable requests on a case-by-case basis.BlueCare Tennessee allowed flexibility to charge inpatient rates in the emergency room or other units where patients may need to be housed, based on intensity of service.These flexibilities expired May 11, 2023: You can also refer to the Provider Administration Manual for more information.īelow, we’ve outlined some of the steps we’ve taken in response to the COVID-19 emergency. Please continue to visit this section of the website for updates. With the National Public Health Emergency ending on May 11, 2023, we’re taking steps to return to some of our original policies and procedures. Throughout the COVID-19 pandemic, we made changes to help our members and providers stay safe.
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