Address unresolved claim appeals
Blue Cross and Blue Shield of Florida and Health Options takes every step to resolve claims issues. If a payment amount issue cannot be resolved, submit an appeal to the Statewide Provider and Health Plan Claim Dispute Resolution Program.
Avoid BlueCard/Medicare claim denials
Blue Cross and Blue Shield of Florida and its HMO subsidiary, Health Options, continue to streamline processes and eliminate authorizations where possible.
Gastric bypass surgery excluded in 2005
Because of member safety concerns and our goal to maintain product affordability, Blue Cross and Blue Shield of Florida and Health Options have joined other health plans in excluding coverage for weight-loss surgeries and services beginning Jan. 1, 2005.
HMO labor check authorization cut
Blue Cross and Blue Shield of Florida and its HMO subsidiary, Health Options, continue to streamline processes and eliminate authorizations where possible.
Maintain privacy
Blue Cross and Blue Shield of Florida and Health Options respect member privacy and have policies and procedures in accordance with the Privacy Rule to safeguard personal information in all forms – spoken, written and electronic.
Need to change your Availity® PAA?
Your Primary Access Administrator (PAA) is responsible for your office’s Availity electronic transactions. Please update Availity when your PAA changes:
PHS agreements apply to BlueOptions, BlueChoice
As a contracted provider in Blue Cross and Blue Shield of Florida’s network, you may be seeing members enrolled in BlueChoice and BlueOptions and have questions about how your provider agreement applies to them, including issues such as balance billing.
You can reduce claim rejects
Rejected claims delay payment to your hospital and the rework involved wastes your staff time. As we all know, time is money.