Medicare AdvantageAdministrativeMedium impact
One to One for Healthcare - Spring 2021 Edition
Blue Cross of Idaho·ID·Medical Policy
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho Spring 2021 newsletter provides policy updates including billing guidance for annual wellness visits, CMS interoperability requirements, chronic condition documentation, and Medicare Part D/B prior authorization submission processes. Key billing changes include ability to bill both AWV and preventive exams on same date and clarification that the Medicare 365+1 day rule does not apply to Blue Cross of Idaho MA or QHP members.
Action Required
Billing team should update AWV billing procedures to allow same-day billing of annual wellness visits and preventive exams when documented separately. Ensure Medicare Part D prior authorization requests are submitted to Blue Cross of Idaho Rx (833-293-0661 or CoverMyMeds) and Part B medication requests to Blue Cross of Idaho. Train providers on chronic condition documentation requirements - avoid 'history of' language and document ongoing management of lifelong conditions.