October 31, 2013





BC-13-22
MS-13-22

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:

Electronic Provider Access (EPA) capabilities for providers servicing out-of-area members

The Blue Cross and Blue Shield Plans are launching a new tool on January 1, 2014 known as Electronic Provider Access (EPA).  EPA will give providers the ability to access out-of-area member’s Blue Plan portals to conduct electronic pre-service review through a secure routing mechanism.  The term pre-service review is used to refer to pre-notification, precertification, pre-authorization and prior approval, along with other pre-claim processes.  Once in the member's Home Plan portal, the out-of-area provider will have the same access to electronic pre-service review capabilities as the member's local providers.

The availability of EPA on January 1, 2014, will vary depending on the capabilities of each Blue Plan.  Some Blue Plans will be fully implemented and have electronic pre-service review for many services, while others will not yet have implemented electronic pre-service review capabilities. 

Detailed information will be provided in December through eNews (email notification) to BCBSKS providers on the EPA for pre-service review.  BCBSKS will provide information letting providers know what they can expect when attempting to contact member's Home Plans at different stages of the EPA implementation. 

Please share this email with anyone in your facility that submits inpatient precertification and may be impacted by this initiative.  If you have questions, please contact the BCBSKS Education Coordinator at 1-785-291-7236.


 

cw