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Blue Shield Requires Physicians to Notify Patients Before Referring Out-of-Network

On March 15, Blue Shield announced that it would soon begin requiring contracted physicians to notify patients in writing before making out-of-network referrals. Effective May 15, physicians will be required to notify patients in writing using a form provided by the payor when referring a patient to an out-of-network provider.

End-to-end Testing Will Ensure Streamlined Transitions to Updated HIPAA Transactions and Operating Rules

Centers for Medicare and Medicaid Services awarded a grant to the National Government Services to develop and pilot an end-to-end testing process through the End-to-End Testing Industry Collaborative Partner (ICP) work group. This process is intended to be used for all future operating rule and standard system updates, as well as the pending ICD-10-CM update.

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