Holiday office closure schedule - New Year's (12/27/11)
Our offices will be closed on Monday, January 2 in observance of New Year’s Day.
Holiday office closure schedule - Christmas (12/19/11)
Our offices will be closed on Friday, December 23 and Monday, December 26 in observance of Christmas.
Annual Wellness Visit Program reminders (9/1/2011)
If you have received a request for medical records for the Annual Wellness Visit Program, please submit them promptly to receive your payment. Payments for this program are sent quarterly.
Medicare requires several new encounter components in order for a visit to be eligible to be reported as a wellness visit with one of the following Healthcare Common Procedure Coding System (HCPCS) codes:
- G0438 Annual wellness visit, includes a personalized prevention plan of service (PPS), initial visit
- G0439 Annual wellness visit, includes a personalized prevention plan of service (PPS), subsequent visit
Please remember to complete and document all required components for a Medicare annual wellness visit and submit these claims appropriately. Learn more about the eligible codes.
The Annual Wellness Visit Program encourages Regence MedAdvantage members to schedule an annual wellness visit with their physician or other health care professional. Find out how to participate.
Customer Service for ASO and UMP will be unavailable on Friday, December 16 (12/13/11)
On Friday, December 16, the Administrative Service Only (ASO) and Uniform Medical Plan (UMP) Customer Service phone lines will be closed from 11:30 a.m. to 1 p.m. for an employee meeting. We apologize for any inconvenience this may cause you.
Member Explanation of Benefit (EOB) mailing schedule change (10/17/11)
Beginning October 17, 2011 we will begin mailing EOBs to our members every 14 days instead of daily. This will apply to all member EOBs except Regence MedAdvantage and the Federal Employee Program.
This change will not impact our timely processing of claims or the frequency of claims payments to our providers.
Generating an EOB summary statement twice a month instead of daily will result in a 29% decrease in claims documents mailed to our members and supports our corporate initiative to integrate sustainability measures into our processes.
Member wellness and care reminder program (10/5/11)
Our new member wellness and care reminder program is designed to communicate the importance of receiving annual wellness examinations, screenings and routine laboratory tests. The program applies to our Regence MedAdvantage and Federal Employee Program (FEP) members.
Eligible members will receive automated interactive voice response (IVR) phone calls and letters with a reminder about the importance of receiving the health care services they need before the end of this year. Phone calls will be conducted in October. Letters will be mailed in November. We have contracted with Silverlink Communications, Inc. to perform these phone calls and mailings on our behalf.
We are focusing on members who have not received one or more of the wellness or care screenings listed below:
- Glaucoma testing
- Cholesterol screening
- Breast cancer screening
- Osteoporosis management
- Annual wellness examination
- Colorectal cancer screening
- Diabetes care, including:
- Eye examination
- Hb1Ac screening
- Cholesterol screening
- Healthy kidney function test
View member cards and search for 30 days of claims on the Provider Center (9/6/2011)
Several enhancements were recently deployed on the Provider Center, including the following new features.
Member cards
Regence member cards now appear on the Member Search results screen. These images can be viewed or printed. Member cards are available for members on our Individual, group and Medicare products, except for Federal Employee Program (FEP) and Uniform Medical Plan (UMP) members.
Simply select the member card icon in the Member ID, Group ID, ID Card column to view the image.
Search for 30 days of claims
You can now search for 30 days of claims. Previously, it was two weeks.
Average wholesale price (AWP) primary source change: Effective September 28 (8/31/2011)
First DataBank (FDB), our primary source for obtaining average wholesale price (AWP) for medications, has recently announced that they will be discontinuing publication of the Blue Book Average Wholesale Price (BBAWP). Effective September 28, all National Drug Code (NDC) records containing AWP price values will be removed from BBAWP and AWP pricing will no longer be available from First DataBank.
We will begin using Medispan as our primary source for AWP beginning September 28. This change should not impact our pricing of medical drug claims.
Claims processing delay update (8/17/2011)
We are pleased to report that we have made substantial progress in reduction of our claim payment delays since our last update. Regence BlueShield of Idaho is now processing claims within our standard timeframes for our group, Individual, Medicare and other product lines.
If you continue to experience payment delays, please check the Provider Center prior to re-submitting claims. In most cases, claims have been received and are in process.
We do need to advise you that we are still tackling our claims inventory for the Uniform Medical Plan (UMP) and will not meet our goal to be within normal claims inventory by September 1 as we had hoped. We will keep you apprised of our progress on this issue.
We would like to thank you for your patience during this period and apologize for the inconvenience this has caused.
HIPAA 5010 FAQ updated (8/2011)
Paper claim submitters, please obtain an NPI. - (7/06/2011)
Paper-based claims transactions (CMS-1500, UB-04 and ADA J400-J404) will soon be required by Regence to include a National Provider Identifier (NPI) along with your tax identification (ID) number. If you do not yet have an NPI apply now.
Electronic submitters, please discontinue use of your Regence provider identifier on electronic claims transactions. Please submit only your NPI and tax ID number on electronic transactions. If you feel the Regence provider identifier is necessary for proper reimbursement, please contact your provider consultant to discuss options.
Medicare file error update (6/16/11)
Last month, we submitted a member eligibility file to the Centers for Medicare & Medicaid Services (CMS) which incorrectly indicated Regence as primary to Medicare for members who are on a retiree policy. The file should have indicated that Regence is secondary to Medicare for these members.
CMS loaded our incorrect file and denied the impacted claims. Providers did not receive payment and members received Explanation of Benefits from CMS for these denied claims.
CMS has now received and loaded a corrected member eligibility file and will begin automatically reprocessing the incorrectly denied claims. This process will take approximately three to four weeks and will capture 70% of the impacted claims.
Providers can wait four weeks to see if they receive payment or resubmit any impacted claims. Medicare beneficiaries with concerns should call 1 (800) Medicare.
Claims for Regence MedAdvantage members were not impacted.
Regence MedAdvantage primary care network survey (8/17/2011)
We recently mailed our annual access and availability survey letters to Regence MedAdvantage primary care providers. We are conducting this survey online. If you received the letter, please complete the survey as soon as possible, but no later than September 9.
Access the survey
The letter included a personalized password for your clinic. If you have difficulty accessing the survey or need your password, please contact Kerry Light.
August 22-26 is National HIPAA 5010 Testing Week (8/2011)
The Annual Wellness Visit Program encourages Regence MedAdvantage members to schedule an annual wellness visit with their provider. Find out how to participate. (7/28/2011)
835 Remittance Advice enhancements (7/2011)
Appeals section of the Administrative Manual updated (7/2011)
HealthSense 65 medical record audit request (6/2011)
HealthDataInsights (HDI) to perform hospital audit services (6/2011)
Update your information in our Provider Directories (6/2011)
Electronic claims attachments now accepted. Learn more and register today. (6/2011)
View the list of health care reform-related preventive services covered at 100% (no deductible, copayment or coinsurance) for most of our members (6/2011)
View our revised pre-authorization requirements notification effective August 1 (5/2011)
Update your information in our Provider Directories (6/9/11)
Please help us maintain accurate Provider Directories by using the Provider Information Update Form or by contacting your provider consultant when you have any of the following changes to your clinic or practice:
- A provider leaves your clinic
- Your clinic/practice is no longer in business
- A physician, dentist, other health care or dental professional joins your clinic
- Change of address, phone number, tax identification or National
- Provider Identifier number
Thank you for your assistance in helping us keep critical information about your practice up-to-date.
Claims processing delay update (6/17/2011)
We are currently experiencing some claims payment delays relative to our first of the year system transition. We are working to correct the causes of this delay and reduce the claims inventory as quickly as possible.
Most lines of business are impacted, including Individual, Group, Medicare and Uniform Medical Plan (UMP). Note: The Federal Employee Program (FEP) and BlueCard® claims are not impacted.
We expect to be back to normal processing standard timeframes for most products by the end of July. UMP processing will be within our standards by September 1.
If you are experiencing payment delays, please check the Provider Center prior to re-submitting claims; in most cases, claims have been received and are in process.
If you are unable to view your claims on the Provider Center, and they are aged more than 30 days from submission, Provider Customer Service will assist you in verifying claim receipt. Note: Due to call volumes, Provider Customer Service cannot assist providers regarding claims aged less than 30 days from submission.
We would like to thank you for your patience during this period and we apologize for the inconveniences this has caused.
We will continue to provide updates as we work diligently to return to our normal claims processing inventory.
Medicare Pre-authorization List updated: Effective June 1, 2011
Partnering to Heal – Complete this free online patient safety training (5/24/10)
Partnering to Heal, a computer-based, interactive learning tool offered by the U.S. Department of Health and Human Services, highlights effective communication about infection control practices and what it means to help create a “culture of safety” in health care institutions.
The free, 30-minute training includes information on basic protocols for universal precautions and isolation precautions to protect patients, visitors and providers from the most common disease transmissions.
The training promotes these key behaviors:
- Teamwork
- Hand washing
- Communication
- Vaccination against the flu
- Appropriate use of antibiotics
- Proper insertion, use and removal of catheters and ventilators
Complete Partnering to Heal today.
Save up to five minutes per inquiry by using the Provider Center to verify your patients’ eligibility and benefit information. (4/29/11)
This free and secure online tool allows your office to:
- Verify coverage, benefit types and eligibility effective dates
- View patient-specific benefit information, including:
- Office visit copayment and coinsurance amounts
- Deductible, real-time out-of-pocket and coinsurance maximum amounts
- The dollar amount or number of visits he or she has used to date and how much is remaining for benefits with limits (e.g., complementary care and rehabilitation)
- Complete benefit booklet in a PDF format
- Review the status of your submitted claims and view payment information
- Search for and view payment vouchers by provider name, voucher number or check number
Learn more and register for the Provider Center. View this guide for step-by-step instructions on how to view eligibility and benefit information.
Claims payment delays (5/18/11)
Regence is currently experiencing some claims payment delays relative to our first of the year claims system transition. We anticipate returning to normal processing levels in the coming weeks. If you are experiencing payment delays, please check the Provider Center prior to re-submitting claims; in most cases, claims have been received and are in process. Thank you for your patience as we work to improve our systems and service.
June 15 is National 5010 Testing Day (6/9/2011)
View common medical codes used by dental offices (5/11/2011)
New resource helps hospitals improve safety culture (4/26/11)
Hospitals working to improve the safety culture of their organization have a new Web-based resource that provides practical information on the patient safety dimensions used in AHRQ’s Hospital Survey on Patient Safety Culture (HSOPS).
The resource is organized by the dimensions assessed in the HSOPS, such as:
- Teamwork within units
- Overall perceptions of safety
- Feedback and communication about errors
- List of general resources from leading public and private groups involved in patient safety
- Links to useful tools and examples that organizations can use to help improve their safety culture
View this resource.
Register for TRICARE’s annual provider seminars now (3/31/11)
Notice of Medicare Non-Coverage (NOMNC) forms have been updated. Download the latest forms now. (3/8/11)
Updated pre-authorization request form available (3/1/11)
Our updated Pre-authorization Request form (PDF) is used for durable medical equipment (DME), inpatient and outpatient surgeries, and outpatient medical services. The updated format and fields will help ensure we receive the necessary information to efficiently and quickly process your request.
System outage notice: (5/11/2011)
A system outage has made information for some members on the Provider Center inaccessible. Electronic claims submission has also been impacted. We are working to resolve this issue as soon as possible and apologize for the inconvenience.
Updated Group and Individual pre-authorization list available April 29 (4/1/2011)
Share your email address with TriWest (3/1/11)
BlueCard® surveys conducted this spring (2/14/11)
Your office may be contacted via phone by the Blue Cross and Blue Shield Association’s survey vendor, Synovate, to answer questions related to your satisfaction with the BlueCard® Program. The survey will be conducted from February 14 to May 16.
Participants will have the opportunity to evaluate our servicing of claims for out-of-area members via phone and/or an online survey. Synovate may collect participants’ email addresses.
Your feedback is important to us. If contacted, we encourage you to participate.
Credentialing requirements for dental professionals (2/10/11)
On February 1, we implemented the credentialing process for general dentistry professionals. We recognize that strong provider networks are essential for the delivery of quality health care services to our members. Credentialing our physicians, dentists and other health care and dental professionals ensures the quality of our networks, and helps us verify that your license or certification, education and professional conduct meet participation criteria required by network standards.
Our credentialing criteria are consistent with national accreditation standards as established by URAC, the National Committee for Quality Assurance (NCQA), Centers for Medicare & Medicaid Services (CMS) and state and federal agencies such as TRICARE.
Learn more about contracting and credentialing.
Update your information in our Provider Directories (2/9/11)
Please help us maintain accurate Provider Directories by using the Provider Information Update Form or by contacting your provider consultant when you have any of the following changes to your clinic or practice:
- A provider leaves your clinic
- Your clinic/practice is no longer in business
- A physician, dentist, other health care or dental professional joins your clinic
- Change of address, phone number, tax identification or National Provider Identifier number
Thank you for your assistance in helping us keep critical information about your practice up-to-date.
Behavioral Health fax number and authorization form change (3/2/11)
Behavioral Health has a new fax number and updated Outpatient Treatment Plan (authorization request) forms. All outpatient authorization requests should now be sent to 1 (888) 496-1540.
New features recently deployed on the Provider Center (3/1/11)
The following new features have recently been deployed on the Provider Center:
- Claims search response time is now faster for most members. The navigation, sorting and searching functions have also been improved.
- Claims pended reason codes are now displayed in plain English for most members. In addition to displaying the current claims status codes (completed, pending and in process), pended claims now indicate what is needed to complete the claim process.
- Pre-existing waiting period credits and the member’s original effective date are now displayed. The new feature displays what the waiting period is, if it applies, and also the waiting period credits, if the member has any. The original effective date of the member’s policy is also displayed.
Register for free Web conference on April 29 to learn about Patient Safety Culture (4/26/11)
The Agency for Health Care Research and Quality (AHRQ) is conducting a free 60-minute Web conference on their Medical Office Survey on Patient Safety Culture on Friday, April 29 from 11 a.m. to 12 p.m. (MT).
The session will cover:
- Survey development
- Preliminary comparative results
- Lessons learned from implementation
Facilitators will discuss how patient safety culture perceptions differ between physicians and other medical office staff and how medical office characteristics affect survey results. Also, learn how and when you can submit data to a national comparative database on the survey.
Register today.
New resource helps hospitals improve safety culture
Hospitals working to improve the safety culture of their organization have a new Web-based resource that provides practical information on the patient safety dimensions used in AHRQ’s Hospital Survey on Patient Safety Culture (HSOPS).
The resource is organized by the dimensions assessed in the HSOPS, such as:
- Teamwork within units
- Overall perceptions of safety
- Feedback and communication about errors
- List of general resources from leading public and private groups involved in patient safety
- Links to useful tools and examples that organizations can use to help improve their safety culture
View this resource.
Continued batch delivery delays (2/11/11 through 4/8/11)
We continue to experience unexpected batch delivery delays for American National Standards Institute (ANSI) 835 Electronic Remittance Advices. Delays can be up to three days from our normal delivery dates
Additionally, ANSI 270/271 Eligibility Request and Response transactions have also been impacted and we continue to declare outages.
Both issues have been escalated and are being worked at the highest possible urgency. We apologize for any inconvenience this may cause and will continue to provide updates on the status of these transactions.
Important UMP billing information (2/9/11)
When submitting claims for your Uniform Medical Plan (UMP) patients, please include the three letter alpha prefix and the member number displayed in the ID NO field on the member card. The member number begins with a “W” followed by nine numbers.
If you use the Provider Center to verify eligibility for UMP members, enter only the nine digit member number. Do not include the alpha prefix or the “W” preceding the numbers.
Learn more and view sample member cards.
Unexpected batch delivery delays (1/28/11)
We are currently experiencing delays in all American National Standards Institute (ANSI) 835 Electronic Remittance Advice batch transactions. We anticipate delivery of the delayed 835s early next week.
Additionally, ANSI 270/271 Eligibility Request and Response batch channels have also been impacted and are returning a significant amount of “system not responding” (AAA/42) errors.
Both issues have been escalated and are being worked at the highest possible urgency. We apologize for any inconvenience this may cause and will continue to provide updates on the status of these transactions.
New member cards - please verify member numbers (1/27/11)
Many of your Regence patients received new member cards at the beginning of the year. Ensure prompt and accurate claims processing by:
- Asking the member for the most current member card at every visit. Since new member cards may be issued throughout the year, this will ensure that you have the most up-to-date information.
- Copying the front and back of the card. Use this information when submitting claims and share it with your billing staff.
- Verifying the member number you submit is exactly as it appears on the member card, including the alpha prefix. The three-digit alpha prefix identifies the member's Blue Cross and/or Blue Shield Plan and is critical for eligibility and benefits verification and claims processing.
My Medicine List helps reduce medication errors and improve safety (1/26/11)
The Washington Patient Safety Coalition (WPSC) developed the My Medicine List initiative to improve safety by reducing medication errors. The initiative’s goal is for every person to maintain a current list of all medicine he or she is using and to share this information with his or her health care provider at every visit.
The following free resources and tools are available on WPSC’s website:
Learn more.
Receive federal incentive payments with electronic health records (1/26/11)
Physicians, other health care professionals and facilities treating Medicare recipients can receive incentive payments for adopting and making “meaningful use” of electronic health records (EHRs).
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) directs that patients have the right to the information in their medical records and to share those records with other providers. Once the use of EHRs is widespread throughout the health care community, records can be transferred easily and securely between providers, laboratories, hospitals or health systems.
The U.S. Department of Health and Human Services (HHS) established the Health Information Technology for Economic and Clinical Health Act (HITECH) to provide monetary incentives for health care providers to implement HIPAA-compliant systems that can share information electronically with other systems. View the Medicare EHR incentive payment schedule for eligible providers.
Eligibility requirements
EHR incentives are available to every primary care provider, regardless of whether he or she practices in a solo office or clinic setting. Each provider is responsible to report his or her data individually. Stage 1 of the incentive program begins this year. Additional incentives will be offered in Stages 2 and 3 and will include additional required technical specifications.
The EHR system must be certified to meet the following technical standards of functionality, reliability and security to be eligible to receive the incentive payment:
- Verify that an EHR has not been altered
- Code laboratory results using consistent terminology
- Record treatment, payment and health care operations disclosures
- Send prescriptions electronically to mail order and retail pharmacies
- Record, modify and retrieve patients’ medication lists, dosages and histories
- Share lists of problems, allergies, diagnostic test results, etc. with providers and patients
- Encrypt and decrypt electronic health information during transport to other providers’ systems
- Send laboratory results, syndromic surveillance and immunization data to public health agencies
- Provide ambulatory and hospital quality measurement data to the Centers for Medicare & Medicaid Services (CMS)
- Record the date, time, patient identification and user identification when an EHR is created, modified, accessed or deleted
Regional Extension Centers (RECs)
HHS has authorized area organizations, collectively referred to as Regional Extension Centers (RECs), to help providers understand and adopt the meaningful use criteria and certify EHR systems. These organizations are responsible to provide the following services:
- Workflow analysis
- Assess current EHR systems
- Assess providers’ initial readiness
- Health information exchange assistance
- Counsel providers in the appropriate selection tools
- Project management and implementation assistance
Contact Qualis Health, the authorized REC in Idaho, for more information.
We support the efforts of HHS to promote electronic health records and encourage you to investigate and use these resources.
Learn more about the EHR Incentive Program.
Please do not submit duplicate claims (1/12/2011)
If you have submitted claims, they are in our system. Please do not resubmit claims. Duplicate claims inflate our inventory and may cause additional delays in processing. We are processing all claims as quickly as possible.
Please use the Provider Center for basic claim status (if the claim has been received, is in process or has been completed).
Washington state launches a new flu education program (01/06/11)
The Washington State Department of Health offers free materials and resources for physicians and other health care professionals to increase influenza vaccination rates. The tools include:
- Sample patient letters
- Screening questionnaires
- Flu vaccine planning worksheets
- Influenza administration request forms
- Brochures, fact sheets, posters and stickers
Providers may receive copies by emailing the state the following information: the item’s name, quantity, provider office’s contact name and mailing address.
The new flu education program also has information for your patients. The campaign reminds people of the importance of getting vaccinated against the flu and includes television, radio ads and billboards.
New Medicare requirements for home health and hospice (12/27/2010)
Effective January 1, the Patient Protection and Affordable Care Act implements a new law for Medicare providers that requires the physician or other health care professional to perform a face to face examination of the patient when certifying or recertifying home health care or hospice services. For home health, the provider must document who saw the patient and how the patient’s clinical condition supports a homebound status and need for skilled care services as part of the certification for home health services.
The face-to-face encounter must occur within 90 days prior to the start of home health care, or within 30 days after the start of care. For hospice, the face-to-face encounter must occur no more than 15 calendar days prior to recertification. While the long-standing requirement for providers to certify the need for home health and hospice remains unchanged, this new requirement assures that the order is based on current knowledge of the patient’s condition.
Learn more (PDF) about the implementation of this law.
Avoid call wait times, use the Provider Center (12/22/2010)
In January, we anticipate higher call volumes to Customer Service due to our members’ benefit changes, which may lead to longer wait times.
As a reminder, your office can quickly and easily find most information for your patients using the Provider Center, our secure Web-based tool.
The Provider Center allows your office to:
- Verify patient coverage, benefit types and eligibility effective dates
- View patient benefit information, including office visit copayments and major medical information
- View deductible, real-time out-of-pocket, and coinsurance maximum accumulation amounts
- Review the status of your submitted claims and view payment information
- Search for and view payment vouchers by provider name, voucher number or check number
Learn more and register for this free tool.
Please note: In some cases, a member’s benefit detail may not be available for viewing online in January.
Best times to call Customer Service
If you are unable to find the information you need via the Provider Center, we encourage you to contact Customer Service on the following days and hours to reduce the amount of time your office spends on hold:
- Days: Wednesday and Friday
- Hours: 7 to 9 a.m. (PT)
Our goal is to provide you with quality customer service. We apologize for any inconvenience and appreciate your patience.
2011 Boeing behavioral health benefits, claims and appeals changes (12/16/2010)
Effective January 1, 2011, the following mental health and substance abuse benefit and claims and appeals administration changes will apply to The Boeing Company plans:
Benefit administration
ValueOptions® will continue to manage mental health and substance abuse benefits for most Boeing plans. Contact ValueOptions at 1 (800) 892-1411 or use ProviderConnect to verify member benefits and eligibility.
Claims and appeals
For dates of service prior to January 1: Submit claims and appeals to Regence BlueShield.
- Pre-certification requirement for routine outpatient care has been removed. Some outpatient services will continue to require pre-certification. Contact ValueOptions to verify benefits and eligibility.
- Detoxification is now covered under behavioral health benefits for all plans managed by ValueOptions. These services will require pre-certification or notification.
- Pre-certification or notification requirements for inpatient and alternative levels of care continue to be managed by ValueOptions. Submit clinical information to them for medical necessity determination.
For dates of service on or after January 1: Submit claims and appeals to ValueOptions. Claims can be submitted electronically or via paper to:
ValueOptions
P.O. Box 1290
Latham, NY 12110
Benefit accumulators added to the Provider Center (10/29/2010)
The Provider Center is a free, secure Web-based tool that allows you to access valuable information for our members.
We recently made this tool even more useful for you and your office staff by adding 30 additional benefit accumulators, including those for:
- Vision
- Dental
- Rehabilitation
- Up front office visits
- Complementary care
These accumulators are available for members on the following products:
- Medical – Regence EvolveSM Individual and Family, Regence Bridge, Innova®, Engage®, ActivateSM and Regence HSA Healthplan 2.0SM
- Dental – EncoreSM, RadianceSM and ExpressionsSM
Nearly 100 accumulators will be added for these members by the end of the year.
You can use this tool to:
- Verify coverage, benefit types and eligibility dates
- View benefit information, including office visit copayments
- View deductible, real-time out-of-pocket and coinsurance maximum information
- Search for and view payment vouchers by provider name, voucher number or check number
Learn more about and register for our Provider Center.
Provider data audit in progress (1/11/11)
Regence sends provider information to the Blue Cross and Blue Shield Association on a weekly basis. This information is published in the National Blue Doctor & Hospital Finder and the Federal Employee Program (FEP) Online Provider Search.
An audit is conducted each quarter by ThoroughbredTM Research Group to validate the provider information (e.g., name, address, phone number, specialty).
Your office may be contacted by Thoroughbred Research this month. We appreciate your help with validating your information.
Provider satisfaction survey results (12/22/2010)
The results of our annual physician and BlueCard® satisfaction surveys are included below.
Physician Satisfaction Survey
We appreciate all of the physicians who completed our annual Physician Satisfaction Survey this year.
Results indicate:
- 87% of physicians would likely continue to contract with Regence
- 76% of physicians felt Regence’s performance was better than other health plans
Our areas of strength include:
Suggested areas for improvement include:
BlueCard Customer Satisfaction Survey
This year’s results indicate an overall increase in provider satisfaction with the program (compared to 2009 results).
Specifically providers reported increased satisfaction in the following areas:
- Timeliness of claims payment
- Efficiency of the pre-certification/pre-authorization process
- Accuracy, timeliness and completeness of eligibility information received
We are pleased that our providers experienced these improvements related to out-of-area members.
Surveys continue next year
Surveys will be conducted in the spring and summer. Your feedback is important to us. If your office is contacted, we encourage you to participate.
Learn more about the BlueCard Program.
Important fee update information (12/10/2010)
Fee update information was recently sent to your office on November 15. Please locate this important information and review it at your earliest convenience.
Survey for Regence MedAdvantage providers (12/07/2010)
Regence MedAdvantage network providers recently received a letter requesting they participate in a short network availability survey.
The letter included a personalized password for your clinic. Please use this password to complete the survey online by December 31.
Once you open the survey and enter your password, you will see a list of physicians or other health care professionals under your tax identification number who currently participate in the Regence MedAdvantage network. For each provider, please indicate if he or she:
- Was accepting new Regence MedAdvantage patients on January 1, 2010
- Will be accepting new Regence MedAdvantage patients on January 1, 2011
If you have difficulty accessing the survey or need your password, please contact your provider consultant.
Provider Customer Service hours change (12/01/2010)
Effective January 1, 2011, our general Provider Customer Service phone line will be open from 7 a.m. to 5 p.m. (PT). This is a change from our previous hours of 6 a.m. to 6 p.m. (PT). View phone numbers and our hours.
New member cards (11/23/10)
Many of your Regence patients will receive new member cards at the beginning of the year. Ensure prompt and accurate claims processing by:
- Asking the member for the most current member card at every visit. Since new member cards may be issued throughout the year, this will ensure that you have the most up-to-date information.
- Copying the front and back of the card. Use this information when submitting claims and share it with your billing staff.
- Verifying the member number you submit is exactly as it appears on the member card, including the alpha prefix. The three-digit alpha prefix identifies the member's Blue Cross and/or Blue Shield Plan and is critical for eligibility and benefits verification and claims processing.
Pre-authorization lists updated, effective November 1 (12/22/2010)
All facilities must be credentialed, effective November 1 (12/22/2010)
Interactive
Voice Response (IVR) - Receive eligibility and claim status via phone (12/22/2010)
Provider Center – Benefits summary screen redesign along with adding new accumulators (9/23/10)
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