Past Issues

Blue Cross and Blue Shield of Florida (BCBSF) is seeking to become a subcontractor providing network services for the TRICARE South Region.

Physicians are the first line of defense in helping patients control hypertension (HTN). Together with Blue Cross and Blue Shield of Florida, our education efforts can make members aware of the dangers of hypertension and the lifestyle changes that can help them manage their blood pressure.

Beginning Oct. 6, the CareCalc^SM member responsibility estimating tool was introduced to more than 115 outpatient facilities, bringing acute care general hospitals and ambulatory surgical centers the ability to determine a member’s financial responsibility for routine outpatient services rendered.

Birthing centers provide an important service to Blue Cross and Blue Shield of Florida and Health Options members. Only HMO members require a referral.

Physicians and providers who participate in the BlueMedicare^SM PPO network may now be seeing patients covered under the BlueMedicare Group PPO plan.

On Nov. 10, 2007, ClaimCheck^® system will be updated resulting in some procedure code changes.

Physicians and providers should allow 30 days after receiving Medicare payments before filing a secondary payment claim to Blue Cross and Blue Shield of Florida (BCBSF).

The first phase of Federal Employee Program (FEP) professional claims began processing on a different system Sept. 24, 2007. The second phase is scheduled to begin Nov. 12, followed by supplier, subscriber-submitted and dental claims Dec. 17.

Blue Cross and Blue Shield of Florida (BCBSF) offers Electronic Funds Transfer (EFT) services for most claim payments. EFT enables you to receive claim payments directly deposited into your bank account and is faster than transferring funds by check.

Using the right CPT and ICD-9 diagnosis codes can help ensure your claims will be processed correctly and avoid delays.

In 2007, claims for 50 national accounts with employees in Florida moved to the BlueCard processing system.

Following these helpful tips will improve your BlueCard^® claim experience.

A record 132 million doses of influenza vaccine is available this flu season. Centers for Disease Control and Prevention (CDC) Director Julie Gerberding recommends encouraging flu vaccination throughout the fall and winter for anyone wishing to be protected.

Major depression is a common illness affecting roughly 15 percent of the population at sometime during their lives. Diagnosis and treatment with medications and other therapies are key factors in successfully managing depression.

As of Sept. 22, 2007, Blue Cross and Blue Shield of Florida (BCBSF) began requiring the NDC quantity and unit price along with the 11-digit National Drug Code (NDC) on claims¹ submitted for specialty injectable drugs, including CuraScript^® and OptionMed^® claims.

Blue Cross and Blue Shield of Florida and its HMO subsidiary, Health Options, want to ensure the quality of care for members. Ambulatory Surgical Center (ASC) accreditation is required for participation in all our networks.

At its 9th Annual Disease Management Leadership Forum, the Disease Management Association of America (DMAA) honored Blue Cross and Blue Shield of Florida for Outstanding Leadership in Emerging Health Needs.

As of Oct. 31, 2007, the Centers for Medicare & Medicaid Services (CMS) requires all Medicare Part B contractors to reject Part B claims if they include a National Provider Identifier/Provider Identification Number (NPI/PIN) combination that cannot be matched to an NPI/PIN combination in the Medicare NPI crosswalk.

In December 2007, Blue Cross and Blue Shield of Florida (BCBSF) will launch an online Diagnostic Imaging Provider Assessment program to collect, analyze and present key information regarding advanced imaging service providers.

In November, Blue Cross and Blue Shield of Florida (BCBSF) is launching a pilot program to educate members about the appropriate use of emergency room services.