Past Issues

Physicians and providers will soon see new Health Reimbursement Account (HRA) and Flexible Spending Account (FSA) debit cards that have been branded “Blue.”

To help primary care office-based practices meet the standards required for documentation of care, we offer the following medical record-keeping tips, which can facilitate continuity and coordination of member care.

The use of secure electronic technology continues to save time and add convenience to the health care experience. Now, patients of physicians using e-Medicine, powered by RelayHealth^®1, can update their medical history via an online questionnaire in advance of their office visits saving you and your patients valuable time.

Don’t forget that our new Essentials – Routine Care plans are effective Jan. 1, 2007. The offering is part of our portfolio of lower-cost BlueOptions products designed to provide viable plans for the uninsured (particularly service industry group employees) looking for affordable and flexible health care coverage.

Our new Medicare Advantage HMO and PPO plans – BlueMedicare HMO and BlueMedicare PPO – are effective Jan. 1, 2007. The name change and merger of our two HMO plans into one bring our Medicare Advantage products under one umbrella.

More than 50 percent of all deaths in the United States are attributed to poor lifestyle. Unfortunately, many people who consider themselves disease free are unaware of pre-disease risk factors.

As of Jan. 1, 2007, primary care physicians (PCPs) no longer need to notify Health Options when referring a member of BlueMedicare HMO, our newly named Medicare Advantage HMO plan, to a participating specialist.

Blue Cross and Blue Shield of Florida has launched new Blueprint for Health^® programs dedicated to addressing the unique health care needs of our Medicare Advantage—BlueMedicare^SM HMO and PPO—members.

Effective Dec. 28, 2006, Blue Cross and Blue Shield of Florida (BCBSF) implemented changes to the medical coverage guidelines and procedure code edits on radiology services. This applies to all BCBSF and Health Options products.

Blue Cross and Blue Shield of Florida (BCBSF) does not offer a Medicare Advantage private fee-for-service (PFFS) plan to Medicare beneficiaries. However, members from out-of-area Blue Plans that do offer PFFS products may seek services from physicians and other providers in our networks.

Don’t forget to submit a change form!

The Master International License Agreement between the Blue Cross and Blue Shield Association and Allianz AG, as well as the three sublicense agreements for Allianz subsidiaries located in Germany, Italy and the United Kingdom, will terminate Dec. 31, 2006.

Do you have patients who are on aspirin therapy to prevent heart attacks or stroke? The Food and Drug Administration (FDA) warns that taking ibuprofen for pain relief and aspirin at the same time may interfere with the benefits of aspirin.

Federal Employee Program (FEP) benefits have been updated for 2007. Blue Cross and Blue Shield of Florida administers two plans: Standard Option and Basic Option. The FEP member ID number begins with an “R” followed by 8 numbers (i.e., R12345678).

Blue Cross and Blue Shield of Florida’s HMO subsidiary, Health Options, will conduct its 2007 Health Plan Employer Data and Information Set (HEDIS^®) study in provider offices between March and May 2007.

We are pleased to announce the addition of two new groups in Brevard County—the Brevard County Board of County Commissioners (Group # 64572) and Brevard County Public Schools (Group #64573)—effective Jan. 1, 2007. Group employees were able to enroll in our BlueCare HMO or BlueChoice PPO.

Blue Cross and Blue Shield of Florida (BCBSF) and Health Options participate with the Council for Affordable Quality Healthcare (CAQH) as our preferred method for obtaining credentialing information.

The Florida Healthy Kids Corporation (FHKC) selected our BlueOptions EPO plan for its health insurance coverage effective Oct. 1, 2006.

In January, National Imaging Associates, Inc. (NIA) will complete its implementation of an interactive voice response system (IVR) that gives physicians and providers an additional convenient option for accessing information on the status of an authorization request.

Publix Super Markets employees enrolled in the Publix PPO will enjoy improved Ambulatory Surgical Center (ASC) benefits in 2007. The member's responsibility for in-network ASC facility charges will be a $100 copay and not subject to deductible or coinsurance.

Employees of the state of Florida who select the State Employees’ PPO Plan have two options to choose from – a Standard PPO Option or a Health Investor PPO Option. Caremark® administers the group’s prescription drug coverage.

Blue Cross and Blue Shield of Florida’s Medicare Part D plan, BlueMedicare Rx, which becomes effective Jan. 1, 2007, includes two formularies covering a broad list of brand and generic medications. These formularies are different from the formulary used for our non-Medicare products.

Blue Cross and Blue Shield of Florida’s (BCBSF) new pharmacy benefit manager as of Jan. 1, 2007, is Prime Therapeutics LLC^® (Prime).

The Preferred Medication List and updates are available on our Physicians & Providers website at http://www.bcbsfl.com under Pharmacy.