Past Issues

As of Jan. 1, 2008, all 837I electronic claims and UB-04 paper claims without a National Provider Identifier (NPI) in fields identifying the primary provider will be rejected.

Maintaining a good, mutually beneficial relationship with you is very important to us. We’re listening to doctors and making improvements in how we do business.

The much awaited ePrescribe Florida Summit held Nov. 30 through Dec. 2, 2007, in Orlando was a huge success. The conference was the first in the nation devoted to ePrescribing.

With the New Year comes a change in health care coverage for many of your patients. Verifying coverage and benefits for all patients is important to collecting the right amount at time of service. At Blue Cross and Blue Shield of Florida (BCBSF), we’ve made it convenient and easy.

As of Jan. 1, 2008, BlueMedicare^SM HMO is available in three new counties – Hillsborough, Pinellas and Polk – in addition to Broward, Miami-Dade and Palm Beach.

Coverage for Blue Cross and Blue Shield of Florida’s latest Medicare Advantage product, BlueMedicare^SM PFFS (Private Fee-for-Service)¹, began Jan. 1.

As of Jan. 1, 2008, BlueMedicareSM PPO is available in seven new counties Escambia, Lee, Manatee, Marion, Pasco, Polk and Sarasota – in addition to Broward, Hillsborough, Palm Beach and Pinellas.

In February, Blue Cross and Blue Shield of Florida, Inc. (BCBSF) will launch its new limited benefit product line for the individual under-65 market. Simple, practical and affordable, the GoBlue Health Services Card targets the working uninsured in Florida, providing inexpensive health coverage to them and their families.

Most health plans with maternity benefits include coverage for the circumcision of a newborn male. If you are unsure of whether this is a covered service, please call our Provider Contact Center at (800) 727-2227.

Blue Cross and Blue Shield of Florida, Inc. (BCBSF) continues to make the 835 electronic remittance easier to use with enhancements based on feedback received from physicians and providers in our networks.

Effective Feb. 1, 2008, Blue Cross and Blue Shield of Florida, Inc. (BCBSF) will have a new, single address for all claim overpayment refunds.

A Papanicolaou smear taken during a comprehensive preventive visit should not be reported separately.

Only certain in-office services are covered for reimbursement. The following provides information on when charges can apply.

Blue Cross and Blue Shield of Florida (BCBSF) has built a web-based Claims Reconciliation Tool that enables physicians and providers to view through the Availity^®¹ Health Information Network a summary of most claims paid, rejected or pended, including BlueCard^® claims.

Effective Jan. 1, 2008, all Blue Plans will cross over Medicare claims for services covered under Medigap and Medicare Supplemental products.

Beginning Jan. 1, 2008, physicians and providers can get access to Blue Plans’ self-service eligibility and benefit information around the clock.

We have added to our website a new Coordination of Benefits (COB) questionnaire that will help you and your BlueCard^® patients avoid potential claim issues.

On Dec. 13, 2007, Merck & Co. announced it was voluntarily recalling 10 lots of PedvaxHIB^® [Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate)] and two lots of COMVAX^® [Haemophilus b Conjugate (Meningococcal Protein Conjugate) and Hepatitis B (Recombinant) Vaccine]—about one million doses in total—as a precautionary measure.

Nearly one in three American adults has high blood pressure, according to the National Heart, Lung, and Blood Institute.

Did you know that approximately 6 percent of the U.S. population (15.1 million people) reported abusing controlled prescription drugs in 2003?

Three new generic drug equivalents to brand name Ambien^®, Restoril^® and Norvasc^® have been added to our growing Generic Copay Waiver program list.

Blue Cross and Blue Shield of Florida, Inc. (BCBSF) and Health Options, Inc. have expanded two of the three components of the Responsible Rx pharmacy program for BlueOptions, BlueCare and BlueMedicare HMO members effective Jan. 1, 2008.

Effective January 1, 2008, the pharmacy benefits for the Florida Healthy Kids Corporation (FHKC) will be changed. A new restrictive formulary will be implemented in accordance with the Florida Medicaid formulary.

At Blue Cross and Blue Shield of Florida, Inc. (BCBSF), we are always looking for ways to help our members save money on their prescriptions.

Starting Jan. 21, 2008, National Imaging Associates, Inc. (NIA) will review all advanced imaging services for medical necessity on behalf of Blue Cross and Blue Shield of Florida, Inc. (BCBSF).

For 2008, the Federal Employee Plan (FEP) will offer a new Basic Consumer Option High Deductible Health Plan. Benefits are the same as the FEP Basic Option; however, the deductible amount varies.

Blue Cross and Blue Shield of Florida, Inc. (BCBSF) will open its second retail store, Florida Blue^SM, Jan. 7, 2008, in Pembroke Pines.

Blue Cross and Blue Shield of Florida, Inc. (BCBSF) offers an automated, self-service telephone system for providers to inquire about claim status and eligibility and benefits 24 hours a day, seven days a week.

Blue Cross and Blue Shield of Florida, Inc. (BCBSF) has added new offerings to its Discounts from Blue program – Tafford Uniforms and Mother Nature, Inc.

Blue Cross and Blue Shield of Florida, Inc., terminated from its Traditional network Laboratory Corporation of America (LabCorp) as of Nov. 1, 2007, and International Medical Laboratory (IML) as of Nov. 15, 2007.