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November/December 2008

Special Section

Blue Cross and Blue Shield of Florida, Inc. (BCBSF) and our HMO subsidiary, Health Options, Inc., are committed to providing our members with quality care and service. We fully support the standards established by federal and state regulatory agencies and the National Committee for Quality Assurance (NCQA). This special section of BlueLine focuses on the policies that are in place to protect members and provides the results of NCQA’s most recent Healthcare Effectiveness Data and Information Set (HEDIS®) and Consumer Assessment of Healthcare Provider and Systems (CAHPS®) surveys.

HEDIS can identify improvement needs

Health Options received an accreditation level of “Excellent” from NCQA for its commercial HMO product (BlueCare).

Member satisfaction

The Consumer Assessment of Healthcare Provider and Systems (CAHPS®) reports on member satisfaction with services provided by their doctors and health plans. The annual survey covers aspects such as the ability to get care quickly, the timeliness and accuracy of claims processing, and the ease of getting and understanding information from the health plan.

Helping members make informed decisions

In an effort to assist members in making informed decisions about their health care, Blue Cross and Blue Shield of Florida provides a link on its website to the Florida Agency for Health Care Administration (AHCA). The AHCA website provides physician and hospital information on a number of surgeries performed in a particular hospital, whether a physician has medical insurance and when a doctor graduated from school.