Past Issues

The Spring 2008 series of Blue Cross and Blue Shield of Florida’s (BCBSF) popular BlueNews Seminars kicks off April 23 in Stuart.

Availity^®1 has announced it will launch a new web-based ePrescribing application late this spring that will transform the way Florida physicians write and send prescriptions.

Coming soon! Authorized users of Availity^®1 CareProfile will be able to view clinical results of lab tests for Blue Cross and Blue Shield of Florida (BCBSF) members. This enhancement will make BCBSF the first payer in Florida to share clinical lab results. Together with Availity and Humana, BCBSF also was the first to introduce the multipayer-based, electronic health record in the country.

In February, Blue Cross and Blue Shield of Florida, Inc. (BCBSF) launched its new limited benefit product line for the individual under-65 market. The GoBlue Health Services Card is ideal for the working uninsured and early retiree with no coverage or as complementary coverage for those who currently only have a catastrophic policy.

All Health Options treating physicians have the opportunity to discuss any adverse benefit coverage determination based on medical necessity/appropriateness with the medical director who made the decision. An explanation of this procedure is included within each adverse benefit coverage written notification.

The Blue Cross and Blue Shield of Florida, Inc. (BCBSF) website, contains several provider claim-related forms that apply to all BCBSF products.

Effective Jan. 23, 2008, medical necessity review will no longer required for the following breast reconstructive services when performed as a result of a mastectomy for a diagnosis of breast cancer. This applies to BlueOptions, BlueChoice, BlueMedicare PPO, BlueMedicare PFFS, State Employees’ PPO Plan and Federal Employee Program (FEP) members.

On Feb.18, 2008, Blue Cross and Blue Shield of Florida, Inc. (BCBSF) initiated a new process for requesting and receiving documents related to claims.

The Provider Utilization Management (UM) Claim Appeal Form is now available in the Physicians & Providers section of the Blue Cross and Blue Shield of Florida (BCBSF) website at www.bcbsfl.com under Tools & Resources, Forms.

As we continue to evaluate BlueCard performance and improve claims processing, customer service and electronic transactions, your feedback helps us set priorities and streamline operations.

Blue Cross and Blue Shield of Florida is working with the American Cancer Society (ACS) again this year to remind our members of the importance of appropriate colorectal screenings. Colorectal cancer is a major killer of both men and women in the United States.

The recommended immunization schedules for persons aged 0–18 years and the catch-up immunization schedule for 2008 approved by the Advisory Committee on Immunization Practices, the American Academy of Pediatrics and the American Academy of Family Physicians include the following changes from the previous schedules.

Recently, the U.S Preventive Services Task Force (USPSTF) released an updated recommendation on screening for high blood pressure.

Each year an estimated 2 million cases of chlamydia go undiagnosed and untreated, leading to serious health consequences for women. Often, chlamydia does not produce symptoms.

Effective April 1, 2008, Blue Cross and Blue Shield of Florida, Inc. (BCBSF) and Health Options, Inc. will expand two components of our Responsible Rx pharmacy program for BlueCare, BlueChoice and BlueOptions members. Responsible Rx refers to an umbrella of programs including Responsible Quantity, Responsible Step and Responsible Dose programs.

Blue Cross and Blue Shield of Florida (BCBSF) has launched a Diagnostic Imaging Provider Assessment Program, which has been identified as a quality initiative for physicians and independent diagnostic testing centers. Please note that the deadline for completion of the survey has been extended to March 14, 2008.

It’s HEDIS^® season! Once again, Health Options, Inc. will be assessing overall plan performance relative to effectiveness, accessibility and satisfaction with the care delivered to our members. The Healthcare Effectiveness Data and Information Set (HEDIS) is developed and maintained by the National Committee for Quality Assurance (NCQA), the accrediting body for managed care organizations.

As of Feb. 1, 2008, Diagnostic Services, Inc. (DSI) is no longer a participating provider for laboratory services in Blue Cross and Blue Shield of Florida’s (BCBSF) Preferred Patient Care (BlueChoice) and Traditional networks.

Fidelity National Information Services, Inc. (FIS), headquartered in Jacksonville, Fla., is a new Blue Cross and Blue Shield of Florida (BCBSF) customer effective Jan. 1, 2008.