July 12, 2013

 
 
 
 

BC-13-9
MS-13-9
 

To:

All Blue Cross and Blue Shield of Kansas Contracting Providers

From:

Connie Winkley – Education/Communication Coordinator
Institutional Provider Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association

Subject:

Upcoming Changes to the BCBSKS Electronic Inpatient Precertification System with the 2013 InterQual ® upgrade

In order to assist our providers in preparing for the changes to the online precertification system with the implementation of the InterQual upgrade, this newsletter provides some (not all inclusive) information on the InterQual changes. A revised Precertification Manual has been published on our website (www.bcbsks.com) and is attached to this newsletter, as well as other helpful documents that can be found on the BCBSKS Precertification Web page. All hospital staff who submit electronic inpatient precertifications should review this information and become familiar with the new layout of the InterQual screens. Please share this information with anyone who may not be signed up for our email notifications and may not be receiving this important precertification information.

With the release of InterQual 2013, the format and process flow of submitting clinical information remains the same.  Likewise, the condition specific subsets remain the same, although additional subsets have been added.

However, the most notable changes to InterQual with this upgrade include:

Providers are highly encouraged to review the attached BCBSKS Precertification Manual prior to the implementation date of mid-July in order to be familiar with the screen changes and to view other detailed changes and information due to the InterQual upgrade.

NOTE: Important points to remember when loading electronic precerts:

Please use one of the contact numbers listed below to assist with your secure access or precertification questions.

Secure Website Access and General Inpatient Precertification and InterQual Information Connie Winkley – Education Coordinator 1-785-291-7236
Coding for Inpatient Precertification Denny Hartman – BCBSKS Provider Rep for Southern KS Hospitals 1-316-269-1602
Coding for Inpatient Precertification Cindy Garrison – BCBSKS Provider Rep for Northern KS Hospitals 1-785-291-8862
Clinical Questions about InterQual and Medical Criteria BCBSKS Precertification Department 1-800-782-4437
Problems with BCBSKS Secure Access (BlueAccess) BCBSKS Help Desk 1-800-472-6481

Please share this information with any other members of your provider staff that will be affected by this upcoming change to the electronic BCBSKS precertification system. Encourage your staff to sign-up with our eNews to receive future updates regarding precertification that may include valuable information and instructions on the use of InterQual 2013.

Precertification Manual

Completing the Precertification for Discharged Patients

Helpful Hints to BCBSKS Electronic Inpatient Precertification

 

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