Past Issues

Successful preparation for natural disasters, such as a hurricane or even a flu pandemic, is a top priority for Blue Cross and Blue Shield of Florida (BCBSF). We want to help physicians and providers minimize business disruptions and allow your patients, our members, to continue to receive medical care.

Effective July 20, 2009, Blue Cross and Blue Shield of Florida (BCBSF) will implement a Provider Administered Drug Program—a reimbursement and utilization management program for specific injectible drugs administered in the physician office setting.

Blue Cross and Blue Shield of Florida (BCBSF) has scheduled system changes in 2009 to enhance all remittance advices with a focus on the 835 Electronic Remittance Advice (ERA).

Blue Cross and Blue Shield of Florida, Inc. (BCBSF) is introducing Care Comparison, a new transparency-related tool to assist our members as they navigate through the health care delivery system.

Are you looking for ways to drive down the costs of running your business while increasing your cash flow?

Blue Cross and Blue Shield of Florida (BCBSF) now offers BlueMedicare^SM Group Supplement insurance plans. BlueMedicare Group Supplement is available to Medicare-eligible retirees, and their Medicare-eligible spouses, who are age 65 and older.

The Blue Cross and Blue Shield Association (BCBSA) added two new Blue Distinction^® designations to its recognition program in 2009: Blue Distinction Centers for Knee and Hip Replacement^SM and Blue Distinction Centers for Spine Surgery^SM.

Effective April 1, 2009, Blue Cross and Blue Shield of Florida (BCBSF) expanded its member case management services to cover 16 rare chronic conditions previously administered by AccordantCare.

The Miami-Dade Board of County Commissioners and Blue Cross and Blue Shield of Florida (BCBSF) have co-designed Miami-Dade Blue, a new health insurance product targeted at the uninsured in the Miami-Dade County area.

A new Oncology Care Support Program was implemented April 1, 2009 for members diagnosed with cancer, regardless of the stage of cancer or the proposed plan of treatment (surgery, chemotherapy and/or radiation therapy or palliative care).

Have you recently joined one of our provider networks, added a new line of business, added a physician to your practice or hired new staff members in your office? If so, we have tools available to assist you.

On January 16, 2009, the Department of Health and Human Services announced the final rules for changes to the federally mandated Health Insurance Portability and Accountability Act-Administrative Simplification (HIPAA-AS) standard covered electronic transactions (version 5010) and new code set standards (ICD-10).

As part of the Love Settlement Agreement, Blue Cross and Blue Shield of Florida (BCBSF) has launched the Adverse Determination (Medical Necessity and Experimental/Investigational) Appeal process.

Blue Cross and Blue Shield of Florida (BCBSF) has made it easier for you to do business with us by combining all our provider appeal forms into one comprehensive appeal form.

Effective July 1, 2009, Atlantic Marine will add the Provider Paid Health Reimbursement Arrangement (PPHRA) benefit to their employees’ coverage.

Triple-S Management Corporation, the Blue Shield licensee in Puerto Rico, has signed a Definitive Agreement to acquire managed care assets of Blue Cross of Puerto Rico (La Cruz Azul de Puerto Rico, Inc.).

According to the Centers for Disease Control and Prevention (CDC), rotavirus is the most common cause of severe gastroenteritis in infants and young children worldwide.

Blue Cross and Blue Shield of Florida (BCBSF) 2008 claims data show that physicians are prescribing antibiotics for members with acute bronchitis.

On May 12, 2009, CMS announced a final decision to end Medicare coverage for virtual colonoscopies.

Beginning in August 2009, the benefits of existing Individual Under-65 BlueChoice and BlueOptions products are being modified with the introduction of the new generic pharmacy benefit for members with MediScript (BlueChoice plans) and BlueScript (BlueOptions plans). The benefit change does not apply to Temporary Protection Insurance products.

Blue Cross Blue Shield of Florida (BCBSF) offers many of our eligible members the ability to fill maintenance prescription medications up to a 90-day supply at retail pharmacies participating in our Extended Supply Network.

Effective July 1, 2009, Blue Cross and Blue Shield of Florida, Inc. (BCBSF) and Health Options, Inc. will implement two pharmacy program changes involving prior authorization and the Responsible Quantity program.

During 2009 and 2010, 25 brand-name drugs are scheduled to become available in their generic form.

Blue Cross and Blue Shield of Florida (BCBSF) has joined with the Florida Hospital Association (FHA) to establish the Florida Hospital Advisory Panel (FHAP).

Providers who participate in our Medicare Advantage networks should have recently received contract amendments containing updated Centers for Medicare & Medicaid Services (CMS) language requirements for the provider agreement.

The next time you order lab work for a Blue Cross and Blue Shield of Florida (BCBSF) member, you can simply refer them to our website to schedule an appointment with Quest Diagnostics Incorporated.

At its March 20, 2009, meeting, the Physician Advisory Panel overwhelmingly supported Blue Cross and Blue Shield of Florida’s (BCBSF) health care comparison tool, encouraging its deployment.