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1 abr, 2020

COVID-19 medical policy updates…and, a “thank you"

The last few weeks have been an extraordinary time for all of us. This has been a remarkable challenge, something we’ve never experienced before. And with such an impact on the healthcare industry, we’re all directly impacted by it.

Obviously our focus is ensuring that our members continue to have access to the care they need at this time, and your focus is keeping your patients healthy. To that end, we have taken several measures and made significant medical policy changes, retroactive to 18 de marzo, to ensure that those things continue to happen during this pandemic. Here’s a look at what we’ve done:

  • Expanded coverage of telemedicine services by all in-network providers, without cost sharing – These services will be covered at 100% of the in-person fee schedule. This decision came before Governor Raimondo signed an executive order mandating no-cost telephonic care. This is currently in effect until 17 de abril.
  • Extended coverage to telephonic triage by most specialist providers and waived member copays and deductibles for these calls – This policy change will allow for members to get the care they need at a lower cost and in their own homes. The policy change applies to Medicare Advantage members and to commercial (fully insured) customers.
  • Waived member copays and cost shares for diagnostic testing related to COVID-19 consistent with CDC guidelines.
  • Allowed members to fill prescriptions earlier than the standard 30 days.
  • Reimbursed participating primary care providers and behavioral health providers for telephonic triage without member cost sharing.
  • Expanded coverage for telephonic behavioral health services.

All of these revised policies have been updated on our Provider site, and we will continue to update you with alerts as appropriate. Also, we have a thorough and detailed FAQ document available to you after logging in to the Provider site. You can also find information in our frequently updated Coronavirus resource center, as well as FAQs for employers. We are also regularly sharing information through our social media platforms, including Facebook, TwitterLinkedIn, and Instagram.

Additionally, we’ve taken several measures to help control the spread of COVID-19 and also help our members and provider community during this difficult time. Here are some examples:

  • Cancelled classes at our Your Blue Store™ retail locations in early March and eventually closed the stores on 18 de marzo, converting to telephonic support for members at that time.
  • Messaged our high-risk members with important public health information.
  • For high-risk members who we know have tested positive for COVID-19 or may have been exposed to it, we are in contact with them daily to ensure they are remaining isolated and maintaining/continuing home care.
  • Supporting the RI DoH with nurses to help with triage phone calls and assisting their epidemiology team.

Thank you for all that you do

It goes without saying that our community’s healthcare providers are doing extraordinary work right now. You are on the front lines of this health crisis, something we’ve never faced before, and are doing an amazing job on behalf of our entire community. On behalf of all of us at BCBSRI, thank you for everything you are doing – we are extremely proud to call you our partners, now more than ever.