Blue Cross Newsletter
 

 

December 14, 2009    

 

BC-09-15
MS-09-14


 

SA 09-14

To: All Blue Cross Contracting Providers
From:

Cindy Garrison, Education/Communication Coordinator
Institutional Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association

Subject:

Walmart Associates To Obtain Pre-authorization From New Directions For Behavioral Health Services.


Beginning January 1, 2010, Walmart has chosen New Directions as their behavioral health vendor.  New Directions is a full-service behavioral health vendor owned by Blue Cross and Blue Shield of Kansas City.  New Directions is accredited as a Management Behavioral Healthcare Organization by the National Committee for Quality Assurance and has URAC accreditation for utilization management.

Outpatient Services

  • You may provide up to a total of 8 visits to Walmart Associates without pre-authorization or review.
  • You must obtain authorization beginning with the 9th visit.
  • Once you have made a request, you will receive a response from New Directions within 72 hours unless additional information is needed.

Inpatient, Partial Hospital, and Intensive Outpatient Services

  • Prior authorization is required for all inpatient, partial hospital, and Intensive Outpatient services.
  • New Directions will conduct concurrent stay reviews

This new partnership will allow you and your patient's access to review services 24 hours a day, seven days a week, 365 days a year.  Assistance from behavioral health professionals is available 24/7 by calling 877-709-6822.

Filing Claims
Please request patient ID cards from all Walmart associates as some have received new ID cards with a new alpha prefix.

    • Continue to submit all services to BCBSKS.
    • New ID cards will be issued to all Walmart associates who previously had services administered by HCSC or Blue Cross and Blue Shield of Alabama for dates of service Jan 1, 2010.
    • New ID cards issued by BlueAdvantage Administrators of Arkansas will have a WMW prefix.  Services for 2009 should be billed using the old prefix MRT or WLA when applicable.
    • Services on or after Jan 1, 2010 should be filed using prefix WMW to prevent delays and mishandling.
    • It is important to ask for and photocopy the patient's ID card at each visit during the next year, so that you may accurately file claims.
    • Continue to contact BCBSKS for assistance
    • To check eligibility and benefits:
    • Call 1-800-676-BLUE (2583)
    • Via the Web at www.bcbsks.com

     

    CG