Medical Worker Writing

Relieving burden on our providers and members during this health crisis.


CMS is waiving the three night acute care stay requirement for SNF coverage due to the state of emergency declaration. Will Capital BlueCross follow this guideline?

Capital BlueCross does not require a three-night acute stay prior to a SNF admission for Medicare Advantage products.


Will Capital BlueCross be adjusting the length of time a preauthorization is valid before it expires?

Yes.

To relieve some of the burden on our providers and our members during this health crisis:

  • For services that may be delayed due to COVID-19, new preauthorizations will be valid for at least six months.
  • For services that are likely to be impacted by the pandemic, such as: OP surgery, IP electives, DME etc., we have extended existing preauthorizations by six months.

If you experience a problem with preauthorization timeframes, please call the preauthorization line, and we can adjust end dates as needed.


How will other preauthorizations apply during the COVID-19 emergency?

Preauthorizations related to COVID-19 diagnostic tests:

  • Covid-19 tests: no preauthorization is required
  • Laboratory tests - CBC and electrolytes: no preauthorization is required
  • Chest X-rays: no preauthorization is required
  • CT scan chest: preauthorization is waived

Preauthorization will be waived for most services with diagnosis codes on the CDC COVID-19 recommended list. Exclusion include: medical specialty injectable, genetic testing, transplant, reconstructive/cosmetic surgeries, MSK, NIA (with exception of CT scan chest).

The preauthorization portal will provide an auto-approval so providers may continue to receive authorization numbers; however, they are not required for COVID-19-related services.