Specific fax numbers for Pharmacy Prior Authorizations
and Medicare Part D
We have a designated fax line for incoming Pharmacy
Prior Authorizations. We also have a specific Medicare
Part D fax line for enhanced receipt and tracking.
Please use these numbers to help efficiently process
authorizations.
This information is available in the Contact
Us section.
3/8/2010
Walgreens free
blood glucose testing event
The clinic is available to anyone age 18 or older.
All 24-hour Walgreen stores will hold the event on
February 5. Anyone not living near a 24-hour Walgreens
may call 1 (800) 925-4733 or visit Walgreens for
a variety of locations nearest to them. Read
more details about the event (PDF).
2/3/2010
Learn more about how you
can join your peers in the fight against childhood
obesity and diabetes
Last November, the Blue Cross and Blue Shield Association launched the first
pilot of the Good Health Club initiative in five states to help reduce childhood
obesity and prevent future cases of diabetes.
The pilot program consists of an easy-to-use obesity
and diabetes prevention toolkit designed for physicians
that contains convenient physician reference materials
and educational, behavior-changing tools to share with
patients and parents. The toolkit, developed in collaboration
with the American Diabetes Association (ADA), American
Academy of Pediatrics (AAP) and the Centers for Disease
Control and Prevention (CDC), encourages healthy choices
and behaviors. The pilot will conclude in the spring
and the final tool kit will be available for broader
distribution by the end of this summer.
Please join us on Tuesday, January 26 from
3:00 pm – 4:00 pm ET for a special
Diabetes Prevention Webinar about the pilot’s
progress, results from the pre-pilot survey and information
about future participation opportunities. The webinar
will be presented by Alicia Coronas, Director at
the Blue Cross and Blue Shield Association.
Access the webinar and
phone 1 (888) 232-0371, participant code: 611960. Please
enter your name and Plan name in the “name” field.
1/25/2010
Tracer claims no longer accepted
As a reminder, we are
no longer accepting tracer claims. These are claims
that are resubmitted due to nonpayment. They are also
known as rebills, second submissions or duplicate billings.
Please use our Provider
Center for
basic claim status (if the claim has been received,
is in process or has been completed). This process
also applies to tracer claims.
If you are unable to find the information you’re
looking for online, please contact Customer
Service.
1/5/2010
Consultation codes no longer reimbursed
by Centers for Medicare & Medicaid Services (CMS)
CMS no longer reimburses for most consultation codes.
Effective January 1, the only consultation codes still
eligible for reimbursement are follow-up inpatient
telehealth consultation, HCPCS G0406 - G0408.
The savings realized by CMS due to this determination
will be redistributed among existing evaluation and
management (E&M) services. CMS also adjusted its
reimbursement for the surgical global period to reflect
the higher value of office visits during the global
period.
Regence adheres to CMS determinations; therefore,
we have made the same adjustments to our reimbursement
methodology for Regence MedAdvantage and other Medicare
members. We will continue to pay a percentage of CMS
allowances as currently established. No other Regence
lines of business are affected by this change.
12/29/2009
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
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.
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
Coordination of Benefits (COB) is changing
Effective with dates of services on or after September
1, Regence BlueShield has changed the way COB claims
are processed. We are making the change to comply with
a new rule issued by the Office of the Insurance Commissioner
(OIC). We will no longer estimate secondary plan payments
if the primary Plan’s payment amount is unknown.
This new rule applies to all employer groups and Individual
plans. However, Employee Retirement Income Security
Act (ERISA) self-funded groups, Boeing and Medicare
plans are exempt.
For more information, visit the Office of the Insurance Commissioner Web site or contact your provider consultant.
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®, ActivateSM and HSA Healthplan 2.0SM; and our dental products - EncoreSM, RadianceSM and ExpressionsSM. 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®, ActivateSM, HSA Healthplan 2.0SM 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
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.
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 -
June 29, 2009
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
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