When we hear a common or recurring issue, we strive to find a way to relieve or resolve that issue. Below you will find job aids, charts or documentation that provides you with quick and easy to understand information. We encourage you to reference this site often as we create, add and revise items whenever necessary.

Regence Clinical Edit List (formerly By Report Codes Requiring Supporting Documentation)
Along with the codes that require some type of supporting documentation, we have also listed the type of supporting documentation required. The Clinical Edit List is a complete list of cosmetic, investigational and Regence Invalid codes and includes the differences that will apply to both our current claims system and our new system (excluding our Medicare claims system). Editing rules on this list will apply effective November 5, 2007 on claims for our commercial products, and November 5, 2007 for all BlueCard^® claims.

Regence Invalid Codes (including Status B Codes)
Invalid codes are CPT and HCPCS codes that are defined by Regence as invalid codes and are not reimbursable.

Common Alpha-Prefixes for Members (PDF)
This is a listing of the most common alpha prefixes used in the state of Washington and where to submit applicable claims. The list is most helpful when services are performed within the Regence BlueShield service area. This list also indicates when you should summit the claim to Regence BlueShield or Premera Blue Cross. When billing for services for claims using prefixes NOT included on this list, you may continue to bill either Regence BlueShield or Premera Blue Cross.

Administrative Simplification Job Aid (PDF)
Keeping track of all the new changes in healthcare can be challenging. Using this job aid gives your office a quick preview of the administrative policies available and what they can do to streamline and simplify your work processes.

Guide to Claim Vouchers (PDF)
A Guide to Claim Vouchers for your Innova^SM, Engage^SM, Activate^SM, HSA Healthplan 2.0^SM and BlueCard^® (out-of-area) patients are reported on a Claim Voucher. Claims for your patients on other Regence products are reported on separate vouchers.  

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