Past Issues

Eligible Medicare beneficiaries can first enroll in a Medicare prescription drug plan starting Nov. 15, 2005, through May 15, 2006. Enrollment in the program is voluntary. If they join by Dec. 31, 2005, their coverage will begin Jan. 1, 2006.

Beginning in October, Blue Cross and Blue Shield of Florida began marketing its Medicare prescription drug plan, BlueScript for Medicare Part D.

Congratulations to the physicians who enrolled and completed the first year’s participation in Blue Cross and Blue Shield of Florida’s pay-for-performance program, Recognizing Physician ExcellenceSM. Nearly 3,000 physicians, about three out of four who were eligible to participate in the first year, enrolled in the program.

Blue Cross and Blue Shield of Florida and its HMO subsidiary, Health Options, are replacing existing pharmacy benefits with our new BlueScript for Medicare Part D plan beginning Jan. 1, 2006, for all Medicare and More, ActivelyYou^SM and BluePreferred members.

We would like to remind physicians participating in our networks to refer members to other providers participating in the appropriate network to keep member’s costs low.

Preservice authorization from National Imaging Associates, Inc. (NIA) for the therapeutic radiology services indicated in Table 1 is no longer required.

Snowbirds will soon be descending on Florida. With them comes the prospect of Florida physicians and other providers seeing more Medicare Advantage patients from Blue Plans out of state.

Have you applied and received your National Provider Identifier (NPI) through the Centers for Medicare and Medicaid Services (CMS)? If so, notify all interested parties, including payers, clearinghouses and your practice management system (PMS) vendor.

In August, Blue Cross and Blue Shield of Florida began applying a provision in the Publix plan of benefits regarding timely filing of claims.

Some 600 BlueOptions members in the Jacksonville area are testing magnetic strip technology for potential use with our health insurance ID cards. When the ID card is swiped through the card reader, eligibility and benefit information is automatically returned to the requesting physician.

Availity recently enhanced the Availity Gateway in order to better serve its users. Look for easier navigation of the Health Care Services Review and Inquiry (Authorization and Referral) pages, which have been streamlined.

The annual BlueCard provider satisfaction survey is now under way. We value the care you provide to members and your satisfaction is a top priority.

Some Blue Plans require certification/authorization requirements for select outpatient tests and/or procedures (e.g., radiology tests, cardiac procedures) for both HMO and PPO members.

In its Sept. 29, 2005, update, the Centers for Disease Control and Prevention (CDC) estimated between 71 and 97 million doses of vaccine will be available this flu season. Beginning Oct. 24, 2005, influenza vaccine should be made available to all persons, per CDC recommendations.

The National Institutes of Health estimates that 60 percent of the people in the United States with asthma have allergic asthma. Xolair (omalizumab) is a monoclonal antibody that treats allergic asthma by blocking immunoglobulin E (IgE), an underlying cause of allergic asthma symptoms.

This issue of BlueLine is the last to be printed and mailed. Future issues will be emailed or faxed, enabling us to provide more timely information.

Our website provides up-to-date information regarding all of our products, services and procedures. We also offer popular quick reference materials in Spanish.

Benefit information for most Blue Cross and Blue Shield of Florida (BCBSF) and Health Options products is now available in Spanish.

Nearly one in 10 of all foreign-born United States residents live in Florida, making our state one of the most diverse in the country.

Blue Cross and Blue Shield of Florida and Humana plan to launch a payer-based electronic health record in 2006.

Hypercholesterolemia is considered one of the main contributors to coronary heart disease (CHD) in the United States.

The Preferred Medication List and the Blue Cross and Blue Shield of Florida (BCBSF) Formulary are guides for members with three- and two-tier prescription plans, respectively.

Blue Cross and Blue Shield of Florida has launched an educational intervention for our members and their prescribers covering the value of cholesterol-lowering therapy in preventing a cardiovascular event.