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Past Issues

September/October 2006

Feature

Par-to-par HMO referrals eliminated

As of Sept. 30, 2006, primary care physicians (PCPs) no longer need to notify Health Options when referring a BlueCare member to a participating specialist. This also applies when a participating specialist refers a member to another participating Health Options specialist.

To the Physician

Availity®Care Profile closes information gap, improves members’ care

Blue Cross and Blue Shield of Florida, together with Humana and Availity®1, are planning to expand Availity®Care Profile statewide in 2007—the first secure, online payer-based health record in Florida.

e-Medicine

e-Medicine gets to the heart of the matter

Sacred Heart Medical Group, Northwest Florida's largest network of primary care physicians, began offering e-Medicine services to its patients late last year.

Products and Services

Coming Jan. 1st: Blue Precision National Program

A new program, Blue Precision is being launched by the Blue Cross and Blue Shield Association (BCBSA) and other Blue Plans for large National Accounts based outside of Florida.

Hospital/surgical plans cover some non-surgical services

Our new BlueOptions Hospital and Surgical plans are designed for small businesses and individuals who have cost concerns but want health insurance protection in the event of major illness or hospitalization.

Our Medicare Advantage plans are changing, beginning with their names

Beginning in October 2006, Blue Cross and Blue Shield of Florida will introduce its new family of Medicare Advantage products for 2007.

Billing and Claims

BlueChoice PPO claims to begin move to the common claims system

Oct. 1, 2006, we will begin moving BlueChoice PPO claims to our common claims system presently used for HMO, NetworkBlue, most BlueCard® host and some NASCO Control Plan claims.

PPO claims processing for speech therapy refined

At Blue Cross and Blue Shield of Florida we take steps every day to improve the quality of services we offer to our providers.

Use State group’s dedicated P.O. box

Blue Cross and Blue Shield of Florida (BCBSF) has a dedicated postal address for all State Employees’ PPO Plan claims and inquiries.

What should you do if you can’t follow normal business procedures?

Successfully preparing for natural disasters, such as a hurricane or even a flu pandemic, is a top priority.

Electronic Solutions

FEP out-of-pocket expense added to Availity

As of Aug. 12, 2006, the Availity®1 Health Information Network includes additional eligibility and benefit information regarding Calendar Year Deductible and Out of Pocket maximum accumulations for members in the Federal Employee Program (FEP).

New tool calculates costs for you

Wouldn’t it be great to know exactly how much to charge for a service at any time during the patient service cycle?

BlueCard

BlueCard Worldwide® website is en español

The Blue Cross and Blue Shield Association’s BlueCard Worldwide website is now available in Spanish.

Medical Notes

ADA 2006 recommendation: Test diabetics for GFR

The leading cause of chronic kidney failure in the United States is diabetes. High blood pressure is the second.

Program reaches out to at-risk groups

The number of new diabetes cases is increasing at a staggering rate. The Centers for Disease Control and Prevention (CDC) indicates that for children born after 2000, one in three will develop diabetes in their lifetime.

News of Note

Accept Temporary ID letters in lieu of ID cards

Members enrolled in new BCBSF and Health Options groups may receive a Temporary ID letter until they receive their new ID card.

BlueNews Fall Seminar schedule

Mark your calendars! The fall series of BlueNews Seminars is coming your way!

BlueOptions coverage begins Oct. 1 for school board

Physicians and providers in Northeast Florida may begin to see new patients in October, as Blue Cross and Blue Shield of Florida health plan coverage goes into effect Oct. 1, 2006, for the Duval County School Board.

Health Options receives top NCQA rating

The National Committee for Quality Assurance (NCQA) has awarded the rating of Excellent to Blue Cross and Blue Shield of Florida’s (BCBSF) commercial HMO plan, Health Options.

Help create Memories of Love

Physicians and providers dedicate themselves every day to maintaining patient health and quality of life.

HMO process for DME-MS is changing

Health Options’ agreement with management vendor EMP Medical, Inc. (EMP) to coordinate the delivery of the majority of durable medical equipment and medical supplies (DME-MS) will expand to cover all HMO members statewide effective Sept. 25, 2006.

Hospital and ASC manual updated

The Blue Cross and Blue Shield of Florida Manual for Hospitals and Ambulatory Surgical Centers has been updated.

NPI countdown: Use our online notification form

The conversion to the National Provider Identification (NPI) system is only eight months away.