Reimbursement Policy Disclaimer

This Policy is intended only for physicians and other health care professionals. By clicking “I Accept” below, you acknowledge your understanding and agreement with the following:

Description:

• The Regence Reimbursement Policy Manual documents payment methodology for medical and surgical services. THIS REIMBURSEMENT POLICY DOES NOT APPLY TO ANY OTHER COMPANY.

Use:

• Reimbursement Policy is used by Regence to provide consistent and predictable claims payment.

Conflict With Other Documents:

• Reimbursement Policy facilitates the systematic application of Regence subscriber contracts, provider contracts, and medical policies. These documents will govern in the event of a conflict with the Reimbursement Policy.

Restrictions And Limitations:

• Reimbursement Policy is interpreted and applied in the sole discretion of Regence.
• Reimbursement Policy does not determine the schedule of benefits. Rather, Reimbursement Policy supports the schedule of benefits by establishing payment rules, coding hierarchy and related processing systems’ edits. To the extent there are situations not documented in the Reimbursement Policy, coding software guidelines control.
• Reimbursement Policy does not dictate to other BlueCross BlueShield plans how to set allowables for their providers under BlueCard plans.
• Reimbursement Policy does not constitute medical advice and DOES NOT guarantee any results or outcomes.
• Reimbursement Policy is the property of Regence and you are strictly prohibited from using it for any commercial use whatsoever. Commercial use does not include use of the Reimbursement Policy related to benefit payment for health care services received by a Regence member.
• Current Procedural Terminology (CPT^™) codes and descriptions are the property of the American Medical Association with all rights reserved. You are strictly prohibited from using CPT^™ codes for any unauthorized use whatsoever.
• Every effort is made to update the Reimbursement Policy in a timely manner. However, there is no obligation to update this site and the Reimbursement Policy displayed may be out of date.