Past Issues

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

Blue Cross and Blue Shield of Florida (BCBSF) and Health Options recently had a Florida Healthy Kids medical quality chart review performed in Santa Rosa County and surrounding counties in randomly selected primary care physician (PCP) offices for the period Sept. 25–27, 2006.

Until now, physicians could access the Physician Selection Advisor and view education, certification and professional affiliation information for themselves as well as others.

Blue Cross and Blue Shield of Florida will expand access to Availity^®1 Care Profile to physicians statewide during the second half of this year. Gainesville, Jacksonville, Miami and Tallahassee are the first areas outside Tampa where the capability will be deployed. Care Profile is another component of health information technology that is being integrated into our Care Management programs as a standard benefit to our members.

A collaboration of Florida’s leading health plans and provider organizations have joined together to launch a statewide initiative called ePrescribe Florida. The organization was created to ensure that all Floridians have access to the benefits of improved health, safety and affordability through electronic prescribing.

Eye Management Inc. (EMI) manages all participating ophthalmology services for BlueMedicare HMO members in Broward, Miami-Dade and Palm Beach counties. Members and/or physicians should coordinate services with EMI at (800) 329-1152, option 1.

Effective May 21, 2007, you can request and receive through the Availity^®1 Health Information Network more specific eligibility and benefits information. The information will be available not only for Blue Cross and Blue Shield of Florida/Health Options members but for members of the Federal Employee Program, National Account Services Company (NASCO) and other Blue Plans nationwide.

On March 26, 2007, Blue Cross and Blue Shield of Florida (BCBSF) added new remark codes to the 835 Electronic Remittance Advice as required by HIPAA-AS. Claim adjustment reason codes are specifically mandated by HIPAA-AS and are not subject to change by BCBSF.

On April 21, 2007, Blue Cross and Blue Shield of Florida (BCBSF) upgraded its version of ClaimCheck^®, the automated procedure code editing system used in professional claims processing. Installation of the update has resulted in some coding logic changes.

When reporting surgical services for Caesarean sections, coding to accurately reflect assistant surgeon services can be a challenge.

Winn-Dixie Stores, Inc., headquartered in Jacksonville, Fla., introduced a new consumer-driven health plan (CDHP) for full-time associates effective Jan. 1, 2006. The new PPO plan features a Health Reimbursement Account (HRA) and continues to use the BlueCard PPO network for in-network services for covered members.

The Centers for Disease Control and Prevention (CDC) has adopted the recommendations of its Advisory Committee on Immunization Practices (ACIP) to routinely vaccinate females aged 11-12 years with quadrivalent human papillomavirus (HPV) vaccine, Gardasil.

The April 13 issue of MMWR Weekly reports the Centers for Disease Control and Prevention (CDC) no longer recommends the use of fluoroquinolones for the treatment of gonococcal infections and associated conditions such as pelvic inflammatory disease (PID).

Blue Cross and Blue Shield of Florida was ranked "Highest Member Satisfaction among Commercial Health Plans in the South," according to the J.D. Power and Associates 2007 National Health Insurance Plan Satisfaction Study^SM.*

Blue Cross and Blue Shield of Florida is offering Subimo’s (now WebMD's) full suite of health care decision support tools, including Healthcare Advisor^SM, Physician Selection Advisor^SM, Hospital Advisor^SM and Treatment Cost Advisor^SM, in Spanish to accommodate the needs of Hispanic members enrolled in BlueOptions or BlueChoice.

We are redesigning our five online ancillary, hospital and physician manuals into one, titled the Manual for Physicians and Providers. The redesigned manual will be much more user friendly and enhance your ability to find information easily and quickly.

Our online provider directory has a new look, simplified category searches and new capabilities to promote our networks and value-added services.

Appointment scheduling is now available at all Quest Diagnostics owned and operated Patient Service Centers in Florida. The automated service enables members to schedule their appointments at a time convenient for them and will reduce wait times at the centers.

Lack of adherence to prescribed drug therapy is a huge problem that cuts across socioeconomic groups. Multiple studies have shown that only about half of people with chronic conditions in the U.S. and other developed countries continue to take medication as directed.*