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- Modifier 25Modifier 25
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Outpatient Facility Code Edits: Bundling and Revenue CodesOutpatient Facility Code Edits: Bundling and Revenue Codes
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- Outpatient Laboratory Claims: Referring Practitioner RequiredOutpatient Laboratory Claims: Referring Practitioner Required
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- Post Payment Documentation Requests: Facility ClaimsPost Payment Documentation Requests: Facility Claims
- Pulmonary Diagnostic Procedures when billed with E&M CodesPulmonary Diagnostic Procedures when billed with E&M Codes
- Radiology, Preliminary and Double ReadsRadiology, Preliminary and Double Reads
- RadiopharmaceuticalsRadiopharmaceuticals
- Reimbursement and Billing Guidelines for Anesthesia ClaimsReimbursement and Billing Guidelines for Anesthesia Claims
- Removal of Impacted Cerumen Requiring InstrumentationRemoval of Impacted Cerumen Requiring Instrumentation
- Screening and Diagnostic Mammography & 3D TomosynthesisScreening and Diagnostic Mammography & 3D Tomosynthesis
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Telemedicine ServicesTelemedicine Services
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- Telemedicine Services Reimbursement Policy: Temporary Addendum for Horizon BCBSNJ Commercial/ASO plans and productsTelemedicine Services Reimbursement Policy: Temporary Addendum for Horizon BCBSNJ Commercial/ASO plans and products
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- Ulcer Debridement and Ulcer StagesUlcer Debridement and Ulcer Stages
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Utilization ManagementUtilization Management
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- Utilization Management Request ToolUtilization Management Request Tool
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ResourcesResources
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Consumer Assessment of Healthcare Providers and Systems (CAHPS)Consumer Assessment of Healthcare Providers and Systems (CAHPS)
- Consumer Assessment of Healthcare Providers and Systems (CAHPS)
- Focusing on Your Horizon and Braven Health Patients’ Experience: Tools to Help YouFocusing on Your Horizon and Braven Health Patients’ Experience: Tools to Help You
- Discussion Checklist for CAHPS and HOS SurveysDiscussion Checklist for CAHPS and HOS Surveys
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- Cultural CompetencyCultural Competency
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HEDIS ResourcesHEDIS Resources
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HEDIS Measure Guidelines for Behavioral Health ProvidersHEDIS Measure Guidelines for Behavioral Health Providers
- HEDIS Measure Guidelines for Behavioral Health Providers
- Follow-Up Care for Children Prescribed ADHD Medication (ADD)Follow-Up Care for Children Prescribed ADHD Medication (ADD)
- Antidepressant Medication Management (AMM)Antidepressant Medication Management (AMM)
- Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM)
- Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)Use of First-Line Psychosocial Care for Children and Adolescents on Antipsychotics (APP)
- Follow-Up After Emergency Department Visit for Substance Use (FUA)Follow-Up After Emergency Department Visit for Substance Use (FUA)
- Follow-Up After Hospitalization for Mental Illness (FUH)Follow-Up After Hospitalization for Mental Illness (FUH)
- Follow-Up After High-Intensity Care for Substance Use Disorder (FUI)Follow-Up After High-Intensity Care for Substance Use Disorder (FUI)
- Follow-Up After Emergency Department Visit for Mental Illness (FUM)Follow-Up After Emergency Department Visit for Mental Illness (FUM)
- Initiation and Engagement of Substance Use Disorder Treatment (IET)Initiation and Engagement of Substance Use Disorder Treatment (IET)
- Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA)Adherence to Antipsychotic Medications for Individuals with Schizophrenia (SAA)
- Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD)Diabetes Screening for People with Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD)
- Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia (SMC)Cardiovascular Monitoring for People with Cardiovascular Disease and Schizophrenia (SMC)
- Diabetes Monitoring for People with Diabetes and Schizophrenia (SMD)Diabetes Monitoring for People with Diabetes and Schizophrenia (SMD)
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HEDIS Measurement Year (MY) 2023 Provider Tips for Optimizing HEDIS ResultsHEDIS Measurement Year (MY) 2023 Provider Tips for Optimizing HEDIS Results
- HEDIS Measurement Year (MY) 2023 Provider Tips for Optimizing HEDIS Results
- Best Practices Overall for CodingBest Practices Overall for Coding
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- How a value-based primary care provider helps the New Jersey Vaccination ProgramHow a value-based primary care provider helps the New Jersey Vaccination Program
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- Telehealth after COVID-19 – Many doctors agree it's here to stayTelehealth after COVID-19 – Many doctors agree it's here to stay
- Value-based care -- transforming health care with better collaboration and improved health outcomesValue-based care -- transforming health care with better collaboration and improved health outcomes
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