Past Issues

Do you have your National Provider Identifiers (NPIs)? If not, you’ve missed the deadline.

Hospitals and physicians may now choose a dedicated primary care physician, hospitalist group or any participating provider on the medical staff to provide hospitalist services to all Blue Cross and Blue Shield of Florida (BCBSF) and Health Options members. This change, which went into effect June 15, is in support of admitting physicians and those following their patients in the hospital and/or skilled nursing facility setting.

For dates of service on or after June 15, 2007, Voluntary Preservice Coverage Review (VPCR) will no longer be available for the procedure codes listed in the following charts for BlueOptions, BlueChoice and FEP members.

By the end of July, physicians and providers will be able to use CareCalc^SM in all valid places of service. Until now, transactions could only be performed for professional services rendered in an office or ambulatory surgical center. This expansion will be particularly helpful to physicians who render services in an outpatient or inpatient setting.

Effective June 1, 2007, Blue Cross and Blue Shield of Florida’s HMO subsidiary, Health Options, eliminated the authorization requirement for DXA scan/bone density studies for the following procedures when performed within Medical Policy Limits. This change affects all HMO members, including those enrolled in BlueCare and BlueMedicare HMO.

On July 1, Blue Cross and Blue Shield of Florida (BCBSF) introduced affordable new health plan options for Medicare-eligible group retirees and their Medicare-eligible dependents. The new BlueMedicare^SM group products are being offered to employer groups seeking to take advantage of federal programs that ease the burden of providing benefits to retirees. Enrollees must be entitled to Medicare Parts A and B.

On July 1, 2007, Blue Cross and Blue Shield of Florida added enhancements to all existing group and individual BlueOptions plans automatically at no additional cost.

Blue Cross and Blue Shield of Florida (BCBSF) continues to improve the 835 electronic remittance, with additional enhancements that went into effect in June.

Effective May 17, 2007, Blue Cross and Blue Shield of Florida updated the billing requirements for HCPCS code Q3001, Radioelements for Brachytherapy (most commonly referred to as seed implants).

Improvements to our claim processing have reduced the number of medical records providers must submit for routinely covered BlueOptions and BlueChoice PPO oxygen claims and shortened turnaround times for claims payment.

Effective July 1, 2007, Atlantic Marine employees based in Jacksonville, Fla., are covered under a high-deductible PPO plan from Blue Cross and Blue Shield of Alabama and will use the BlueCard PPO network for in-network covered services.

By Jan. 1, 2008, all Blue Plans must have a coordination of benefits agreement (COBA) in place with Group Health Incorporated (GHI) to support the crossover of Medicare supplement claims for all members covered by Blue plans. The new process will eliminate the need for physicians and providers to file separate claims for covered services to secondary Blue licensees. It also will reduce unnecessary duplicate secondary claim submissions.

Patients with diabetes are at significant increased risk for developing diabetic eye disease and blindness. Diabetic retinopathy is the most common eye condition associated with diabetes and causes 12,000 to 24,000 new cases of blindness each year, according to the American Diabetes Association (ADA).

The supply of ProQuad® (MMR-V vaccine) is expected to be depleted this summer and is not expected to be available for the remainder of 2007, according to the CDC.

For a newborn baby, every week closer to the full gestational age of 38 to 40 weeks means the probability of a better clinical outcome.

On July 1, 2007, Blue Cross and Blue Shield of Florida (BCBSF) and Health Options implemented two new pharmacy utilization programs. The programs are designed to help manage the cost of specific drugs by encouraging access to equally effective lower-cost drugs or by implementing coverage maximums.

Blue Cross and Blue Shield of Florida (BCBSF) and Health Options have been participating with the Council for Affordable Quality Healthcare (CAQH) since December 2005. This enhancement to our credentialing program has greatly benefited providers and their office staffs and has become our preferred method for obtaining credentialing information.

Effective July 1, 2007, Federal Employee Program (FEP) members will be enrolled in our Blueprint for Health^® disease management programs, powered by Health Dialog.

We've streamlined the Physicians & Providers section of our website to make it easier for you to find information and resources.

The Centers for Medicare & Medicaid Services (CMS) will grant public access to electronic file downloads of the National Provider Identifier (NPI) Registry and other related data on Aug. 1, 2007.

Successfully preparing for natural disasters, such as a hurricane or even a flu pandemic, is a top priority. BCBSF, together with its network providers, play a key role in making sure potential problems related to natural disasters or other emergencies don’t affect your patients — our members.