Past Issues

Have you been hit with precertification penalties? Penalties apply for inpatient admissions when hospitals do not notify Blue Cross and Blue Shield of Florida’s HMO subsidiary, Health Options, of the admission when Health Options is the secondary payer.

Blue Cross and Blue Shield of Florida is the single point of contact for claim filing status inquiries, claim appeals and general claim information for all BlueCard claims.

Health Options has a financial incentives policy in place that is designed to assist practitioners, providers, employees, and supervisors involved in (or who supervise those involved in) making coverage and benefit utilization management or utilization review (UM/UR) decisions.

Beginning Jan. 1, 2005, General Electric employees and their covered dependents in Florida who are enrolled in the GE Medical Benefits (GEMB-PPO) Plan will be eligible for health care benefits provided by the BlueCard PPO network (identified by the “PPO suitcase” logo on the front of the card).

Beginning Jan. 1, 2005, all Blue Plans will provide uniform, basic information in response to electronic requests for eligibility and benefits information, including copays, coinsurance and deductibles.

Blue Cross and Blue Shield of Florida (BCBSF) has implemented a new edit that checks member and provider identification numbers on electronically submitted claims.

The Centers for Medicare & Medicaid Services (CMS) has authorized several Blue Plans to offer Medicare Advantage (formerly known as Medicare+Choice and Medicare Risk) products in the form of HMOs and PPOs.

Members enrolled in one of the following Blue Plans are covered under the national BlueCard program.

Beginning Jan. 1, 2005, Wellmark Blue Cross and Blue Shield of Iowa will administer health benefits for more than 1,000 employees and retirees of Rockwell Collins.

We wish to take this opportunity to thank you for the commitment you demonstrate in serving Floridians, especially our members.