Is your listing in our Provider Directory correct?

Please help us maintain the accuracy of our Provider Directories by using the Provider Information Update Form or contacting provider services when you have any of the following changes to your practice:

• A physician or other health care professional joins your clinic
• A provider leaves your clinic
• Your clinic/practice is no longer in business
• Change of address, phone number, tax ID or NPI number

11/11/2009

Important Data Security Notice

Regence's business partner, the Blue Cross and Blue Shield Association (BCBSA), recently experienced an unauthorized transfer of data to a laptop that was subsequently stolen on August 25.

For Regence participating providers whose Social Security number and tax identification (ID) number are the same, BCBSA is offering one year of free Triple Alert^SM credit monitoring membership from , ConsumerInfo.com Inc. Notifications were sent to providers at risk on October 9.

If you are only contracted for TRICARE this incident does not apply to you and you received the mailing in error. You can disregard that notice as the BCBSA does not have your data on file.

If you have any questions, please contact Provider Relations.

10/30/2009

New BlueCard^® Provider Customer Service hours

BlueCard Provider Customer Service specialists are now available from 8 a.m. to 4:30 p.m.

09/21/2009

Regence Online Services for Providers will soon have a single login and more member information

This fall, the login process for Regence Online Services for Providers will be simplified by providing a single login. Users will not need to login separately to different systems based on a member's coverage. All Regence member information will be available via this enhanced process. You will also notice a new coverage page that includes member eligibility and benefit information with user-friendly details.

Regence Online Services for Providers allows online access to:

• Member eligibility and general benefits, deductible and coinsurance maximum amounts
• Claim status and payment information
• Payment vouchers by provider name, voucher number or check number
• Member feedback about their experiences with you
• Your individual profile page

Learn more about Regence Online Services for Providers.

09/02/2009

Regence Online Services for Providers Outage Notification

There will be a system upgrade this weekend which will result in limited access to some information. This will only impact patients on our medical products - Regence Innova^®, Engage^®, Activate^SM and HSA Healthplan 2.0^SM; and our dental products - Encore^SM, Radiance^SM and Expressions^SM.

The outage is scheduled to begin at 4 p.m. PDT, on Friday, September 4 and continue through Monday, September 7 ending at 9:00a.m PDT. We apologize in advance for any inconvenience this may cause you.

09/01/2009

Claim Vouchers enhanced

Over the next few weeks, you will notice changes to the Claim Vouchers for your Regence Innova^®, Engage^®, Activate^SM, HSA Healthplan 2.0^SM and BlueCard^® patients.

Enhancements to the main voucher pages:

• A Coordination of Benefits Amount column added
• The Interest Paid column moved to a Claim Interest line in the patient-specific claim information
• Adjusted claims that have an amount to be recovered will be listed in a new “Summary of Adjusted Claims to be Recovered” section. Only original claims and adjusted claims that do not have an amount to be recovered will be listed in the main section.

Other enhancements

• All sections include the provider network (Network ID) for each claim.
• Within each section, claims are sorted by network, patient name and claim number.
• After the main voucher pages, the section order will be:

• Payment Summary
• Summary of Payment Reductions
• Summary of Adjusted Claims to be Recovered
• Pended Claims Summary

View our Guide to Claim Vouchers (PDF)

09/01/2009

Fee Calculator Tool requires secure login

Beginning August 1, our fee calculator tool will require access via a secure login. All registered Regence Online Services for Providers users will be able to continue using the tool with their current user name and password. If you are not a registered user, we encourage you to sign up prior to August 1 to ensure that your access is not interrupted.

Medicare alert to update account information in 48 hours is a scam

The Centers for Medicare & Medicaid Services (CMS) has notified us of a scam where perpetrators are sending faxes to physician offices posing as Medicare carriers or Medicare Administrative Contractors (MAC). The fax instructs staff to respond to a questionnaire to update account information within 48 hours in order to prevent Medicare payment gaps. The fax may have the CMS logo and/or the contractor logo to enhance the appearance of authenticity.

If you receive a request for information that seems suspicious, please check with your contractor before submitting any information. Medicare providers should only send information to a Medicare contractor using the Provider Call Center Toll-Free Numbers Directory found in the download section of the CMS Web site.

07/21/2009

Regence Launches Consumer Engagement Campaign

With health care reform at the center of debate in D.C. and no clear answers on how to achieve a working system, or reign in runaway health care costs, Regence continues in our efforts to educate and engage consumers in becoming more active participants in the health care system.

To help in this long-term endeavor, early this week Regence launched a newly revamped, interactive www.WhatsTheRealCost.org Web site.

This site is part of our ongoing campaign to educate consumers about the real costs of health care, how the choices they make each day impact those costs, and that without addressing costs, we cannot achieve meaningful transformation of the health care system.

This campaign is geared toward all consumers, as the more interactive site will appeal to a variety of demographics. We encourage you to visit www.WhatsTheRealCost.org and experience the various elements of this Web site designed to help people understand the problems facing our health care system, and to inspire them to take action toward meaningful health care reform.

If you have questions about www.WhatsTheRealCost.org please contact your provider consultant.

07/17/2009

Join the Regence Online Network Panel

Regence Online Network Panel gives clinic administrators and office managers the opportunity to participate in surveys and forums about various health issues, trends and initiatives that are important to the community and Regence. If you are interested in joining the panel, please send an email that includes your name, title, office or practice name, and phone number to ronp_support@regence.com.

06/29/2009

Immunization coverage information for Primary Care Providers for children

As you are aware, the state of Idaho has reimbursed providers for childhood vaccine ingredients through the Idaho Immunization Program. For children with insurance coverage, providers have been billing insurers for vaccine administration plus $0.01 for vaccine ingredients for tracking purposes. Effective July 1, the state will no longer provide childhood vaccines for all children with insurance coverage for vaccines, and you no longer may immunize Regence members with vaccines supplied by the Idaho Immunization Program.

Nearly all children insured by Regence have coverage for childhood vaccines and their administration. You may continue to provide these services to Regence members and bill Regence just as you do for any other covered service. We encourage you to immunize Regence members with purchased vaccines, and bill Regence for those vaccines. Depending on the member’s benefit options, vaccines may or may not be subject to deductible or coinsurance amounts. Member-specific benefit information is available on Regence Online Services for Providers.

Regence reimburses childhood vaccines at 110% of the Average Wholesale Price (AWP). This reimbursement amount is updated quarterly, based on current AWPs. This reimbursement methodology will continue in the 2009 Regence fee schedules effective October 1, 2009. Regence allowable amounts for vaccines and vaccine administration are available on the fee calculation tool.

Regence has participated in discussions regarding development of an alternate program to replace the withdrawn state funding for childhood vaccines. An alternate program is being developed, but is not expected to be operational by July 1. The currently proposed program does not allow us to comply with some of our member contract provisions, and does not allow other contract provisions without significant administrative difficulty for both providers and Regence. As a result, Regence is not able to participate at this time in the currently proposed program. Regence is committed to our members, and will continue to provide the existing benefits for childhood immunizations detailed above to its members using our established provider reimbursement and claims payment systems. 

Since an alternate statewide program is not expected to be in place by July 1, we encourage you to consider purchasing an interim supply of vaccines to administer to insured children beginning July 1. For your reference, here are a few resources for purchasing childhood vaccines:

Regence will continue to work with you and others in Idaho to promote childhood vaccinations. We will closely monitor this important issue for Idaho, and participate in discussions seeking a long-term solution. If you have questions, please contact your provider consultant or call Customer Service at 1 (866) 699-8170. The phone number for your provider consultant is available in the Contact Us section.

06/16/2009

Medicare compliance training required for Regence MedAdvantage providers

Effective January 1, 2009, new Centers for Medicare & Medicaid Services (CMS) regulations require compliance training for “first tier, downstream and related entities” of a Medicare Advantage plan. Physicians and other health care professionals who contract with a Medicare Advantage plan, such as Regence MedAdvantage, are considered “first tier” entities. This designation applies not only to Regence MedAdvantage, but to any Medicare Advantage plan with which you contract.

We have developed an online workshop that meets the CMS requirement. Training developed internally or by third parties may also be used. Training must be completed yearly and documented.

It takes approximately 20 minutes to complete the online workshop.

01/27/2009