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Past Issues

March/April 2005

To The Physician

We offer many e-solutions for you

With our goal to make it easier for you to do business with us, we continue to add new e-tools and enhance our other online programs to help your office work with us more efficiently.

Important Updates

Asthma control in children found lacking

One of the nation’s largest and most comprehensive surveys about children and asthma, Children and Asthma in America, shows control of asthma in children falls far short of national treatment goals established by the National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health.

Diabetes care shows mixed results

The Blueprint for Health® Diabetes Program recently concluded a statewide chart review focusing on diabetes care provided for calendar year 2003.

Enroll as an active user in the Florida SHOTS program today!

Now there’s a simple way to keep track of childhood and adolescent immunizations with Florida SHOTS (State Health Online Tracking System).

HEDIS study under way

Blue Cross and Blue Shield of Florida’s HMO subsidiary, Health Options, Inc., is conducting the 2005 Health Plan Employer Data and Information Set (HEDIS®) study.

Look for us at upcoming county and specialty medical society events

Blue Cross and Blue Shield of Florida believes in the importance of working together with physicians and other health care professionals to meet the health care needs of Floridians and is committed to supporting physician education and community-oriented programs.

Products and Services

Now online!

Blue Cross and Blue Shield of Florida has updated its website.

What is a health care services review?

Authorization, certification, notification, referral—so many different terms are used when requesting services for members.

Medical Coverage Guidelines

Dyslipidemia, CVD assessment tests

The following tests are not covered in the diagnosis (all ICD-9 related diagnoses) and management of dyslipidemia and cardiovascular disease (CVD).

Save time: Check MCG online

Is that procedure covered or investigational? What documentation is required to establish medical necessity?

Billing and Claims

Follow CPT guidelines for new patient visits

Blue Cross and Blue Shield of Florida and its HMO subsidiary, Health Options®3, follow CPT guidelines in defining new and established patients for the purpose of reporting evaluation and management services, as well as determining the appropriate billing of such visits.

Refer HMO, BlueOptions clinical laboratory requests to Quest Diagnostics

Quest Diagnostics Incorporated is the network laboratory for members enrolled in our HMO and BlueOptions products.

Electronic Solutions

Specialty E&B coming soon

You’ve asked to receive specific benefit information via Availity’s Eligibility and Benefits response.