Physicians/Specialists
Facilities/Hospitals
Ancillary
Pharmacy
Dental
Publication Date: 
2020-12-21

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) and Pulse8 would like to thank you for submitting your Provider Alerts via the Risk Adjustment application in Blue e for the 2020 Prospective Risk Adjustment program. It has been our pleasure to partner with your office to close risk adjustment gaps for your patients.

 

You still have time to submit your Pulse8 2020 Provider Alerts

Pulse8’s Collabor8 Provider Portal is still accessible through Blue e

  • Click the Risk Adjustment button on the new home page, or
  • Click the link under Health Management

2020 Provider Alerts will be accepted through the end of December

  • There will not be a January runout this year!
  • Dates of service from January 1 through December 31, 2020 will be accepted until December 31, 2020 at midnight
  • Please contact Joe Richard at Joseph.richard@bcbsnc.com or Anita O’Connell at anita.oconnell@bcbsnc.com if you have questions or would like guidance on how to prioritize completing alerts before the year ends.

 

2021 Prospective Risk Adjustment

Prospective Risk Adjustment will undergo several changes for 2021. Many practices have begun participating in the Blue Cross NC Blue Premier and QIP programs, and many independent practices are partnering with Aledade. These programs allow providers to more closely align Prospective Risk Adjustment, Retrospective Risk Adjustment, and Quality efforts.

  • Blue Cross NC will focus Prospective efforts on the Blue Premier programs with increased emphasis on Risk and Quality gap closure 
  • Blue Cross NC will no longer be utilizing the Collabor8 Provider Alerts
  • Persistency Reports and PQR Reports will continue to be utilized to deliver Risk and Quality gaps.

If your practice is not currently participating in one of these programs and you have questions on how you will be able to address Risk and Quality gap closure, please reach out to one of the individuals below. We would be happy to answer your questions and help you get started.

 

Thank you for collaborating with us to help better manage care for your patients!