Regence MedAdvantage is a Medicare Advantage Preferred Provider Organization (PPO) option available to eligible beneficiaries in Clallam, Columbia, Cowlitz, Island, King, Kitsap, Klickitat, Lewis, Pierce, San Juan, Skagit, Skamania, Snohomish, Thurston, Wahkiakum, Walla Walla, Whatcom and Yakima counties.

Product features

• Regence MedAdvantage provides all Part A and B benefits with additional covered services in one plan. Most professional services are covered at 100% after a copayment, or paid in full for in-network providers.
• A Dedicated Provider Customer Service phone number is available for Regence MedAdvantage questions at 1 (877) 508-7362.
• No referral requirements: Members can seek services from any provider on the Regence MedAdvantage network.

Identifying members

Regence MedAdvantage member cards include:

• The Regence BlueShield logo and the Medicare Advantage PPO suitcase on the front
• The member number and a unique three letter prefix of ZVW. The full member number, including the prefix must be submitted on claims.

View 2010 sample member cards »

Obtaining benefits, eligibility or claim information

Use the Provider Center for easy access to benefits, eligibility and claim status for patients with Regence MedAdvantage.

You can also contact Regence Provider Customer Service for these products at 1 (877) 508-7362.

Physicians, other health care professionals and facilities are responsible for pre-authorizing all services listed on the Medicare Products Pre-authorization List »

• View 2010 Summary of Benefits (PDF) »

Claim vouchers

Claim Vouchers for Regence MedAdvantage claims are issued separately. View a sample voucher (PDF) »

Provider networks

Regence MedAdvantage members can seek services from our Regence MedAdvantage providers or non-contracted providers. Visit our Provider Directory to validate your information. You can enhance your provider profile on Provider Center.

We are actively contracting with physicians, other health care professionals and facilities to be included in our Regence MedAdvantage network. Learn more about joining our Regence MedAdvantage network.

If you are providing services for a patient with a Medicare Advantage Private Fee-for-Service (PFFS) plan, you can access the Medicare Advantage PFFS terms & conditions using the Web Finder Tool. Although Regence BlueShield does not offer a PFFS plan, other Blue Cross and/or Blue Shield Plans (Blue Plans) do, and their members may seek services in Washington. As with other BlueCard members, PFFS claims should be sent to Regence BlueShield.

Workshops

• Regence MedAdvantage Online Training: This course will help you identify members, become familiar with benefit structures, and understand our payment vouchers.
• Regence Medicare Advantage Compliance Training Completing this course meets the Centers for Medicare & Medicaid Services (CMS) annual compliance training requirement for providers and their staff.

• NOMNC form (PDF)
• NOMNC Fact Sheet (PDF)

• NOMNC form (PDF)
• NOMNC Fact Sheet (PDF)