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Administrative Manual

Our manual contains dental and medical policy and procedure information that can be used as a day-to-day reference by our providers and their staff.

Notification of content changes
Updates to manual sections are posted at the beginning of the month in which they occur and a notification is included in our newsletter, The Connection OnlineSM. Our newsletter is published in February, April, June, August, October and December. Sign up to receive our newsletters via email. Please review new content promptly to ensure you have the most current information.

Learn more about Regence, view our Code of Business Conduct policy or our Confidentiality information and requirements.

Manual
Section Change
Revision Date
Appeals for all Idaho providers

Updated the up-front filing fee for second level external provider appeals to $50

The separate Dental appeals process was removed as these appeals now follow the same process as other professional providers

Removed references to investigational from the Provider Billing Dispute and Medical Necessity Procedure Determination Appeal Process
5/2012
Appeals for Idaho-contracted providers located in Asotin and Garfield counties in Washington State

 

2/2012
Behavioral Health Updated the Milliman Care Guidelines information
12/2011

BlueCard® Program

Converted to Web-based format
5/2010
Care Management Added information about our Integrated Care Management program
1/2012
Credentialing Converted to Web-based format
8/2010
Facility Guidelines New section
6/2011

Federal Employee Program

Added 2012 benefit information 1/2012
Filing Claims Added ICD-10 information, other billing information and an updated dental billing link
3/2012
Fraud and Abuse Converted to Web-based format
4/2010
Identifying Members

Updated the information about what is displayed on Regence MedAdvantage member cards

1/2012
Medicare Advantage Plans

Updated benefit information for 2012

1/2012
Payment (PDF)

Added information about redesigned Regence MedAdvantage vouchers

1/2011
Quality Program Added information about the Blue Physician Recognition (BPR) Program.
4/2012
Regence Life & Health Dental Products (PDF) Updated contact information
12/2011

Regence Policies

  • Dental
  • Medical
  • Medication
  • Reimbursement
Section renamed. Dental policy information added 8/2011

RegenceRx® Provider Basics

Converted to Web-based format
5/2010

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