bcbsil brings versatile availity platform to illinois providers
Post on 03-Feb-2022
4 Views
Preview:
TRANSCRIPT
Electronic Refund Management (ERM) is here!.... 2
BCBSIL onFacebook.......... 3
Pre-certification & Predetermination Guidelines ......4,5
BlueCard® Tip:Pre-certification Requirements ...... 5
Annual Physician/Practitioner Surveys.............. 6
Update on ‘Michelle’s Law’ ... 7
Fairness in Contracting ........ 7
What’sInside?
Visit our Web site at www.bcbsil.com/providerVisit our Web site at www.bcbsil.com/pro idididddvidvidererer
Care Comparison Tool SupportsTransparency Initiative
July 2009
BCBSIL Brings Versatile Availity® Platform to Illinois ProvidersBlue Cross and Blue Shield of Illinois (BCBSIL) providers now can securely access patient
eligibility and benefits information, request authorizations, and submit and monitor claim
submissions and status via the Availity® Health Information Network. Availity’s secure Web
portal streamlines providers’ most common, time consuming administrative tasks, and
allows them to instantly access information about BCBSIL members. BCBSIL will give
Illinois providers access to Availity at no cost.
In addition, Availity can be expanded in the future to give providers and health plans the
ability to share medical records, health information and other important data, which can
improve quality and efficiency, and ultimately help reduce costs.
“Availity expands BCBSIL’s online functionality and strengthens our online and offline
connections to Illinois providers, which is an important step in BCBSIL’s efforts to provide
solutions that meet physicians’ and hospitals’ administrative needs,” says Steve Hamman,
BCBSIL’s vice president of Network Management.
Julie Klapstein, Availity’s CEO says, “We are pleased to play a role in helping Illinois physicians
and providers streamline their workflow, reduce their costs and improve their relationships
with their patients. Real-time information exchange saves providers and
health plans time and money.”
To learn more about the Availity portal or to enroll, please visit
www.availity.com or call (800) AVAILITY (282-4548).
About Availity, L.L.C. – Patients. Not Paperwork.®
Availity optimizes information exchange between multiple health
care stakeholders through a single, secure network. The Availity
Health Information Network encompasses administrative,
financial, and clinical services, supporting both real-time and batch
exchange via the Web, business to business (B2B) integration, and
electronic data interchange (EDI). For more information,
including an online demonstration, please visit
www.availity.com.
Availity is a registered trademark of Availity, L.L.C.
Availity is a third party vendor, and BCBSIL makesno endorsement, representations or warrantiesregarding any products or services offered by thisvendor. Availity is solely respsonsible for theproducts and services it offers. If you have anyquestions regarding the products or servicesoffered by Availity, you should contact
them directly.
BCBSIL believes that a well-informed
consumer will make better health
care decisions.
As early as September 2009, we plan to
implement a new online Care Comparison
tool that will help our members to review
and compare health care and service costs
for a number of procedures performed at
hospitals, ambulatory surgery centers and
free-standing radiology centers in the
BCBSIL provider network. This tool is a
component of a Transparency Program
that will initially focus on reporting the
costs related to specific procedures
rendered to BCBSIL members, as well
as the total volume of each procedure
performed for all payers.
Communications introducing the Care
Comparison tool have been mailed to
hospitals, ambulatory surgery centers
and free-standing radiology centers in
the BCBSIL provider network. Please
continue to watch the “What’s New”
section of our Provider Web site
at www.bcbsil.com/provider for
additional announcements and
information regarding this and
other BCBSIL initiatives.
Electronic Refund Management (ERM) is here!
You’re invited to an ERM WebinarJoin us this month for a special ERM Webinar where the ERM Training Team
will be happy to show you a demonstration of the new system and its benefits.
If you are interested in attending, send an e-mail to eRM@bcbsil.com with your
preferred session date, as well as your office name and listing of participants.
All dates have a morning (10 to 11 a.m.) and afternoon (2 to 3 p.m.) session.
• July 6, 2009 • July 16, 2009
• July 8, 2009 • July 20, 2009
• July 14, 2009 • July 22, 2009
Visit our Web site at www.bcbsil.com/provider 2
We're pleased to introduce ERM – a new online refund management tool
that will help simplify overpayment reconciliation and related processes.
Here are some of the practice enhancing features ERM has to offer:
• Single sign-on – If you are currently a registered Availity or RealMed®
user,* just complete an online on-boarding form (see instructions below)
to obtain access to ERM through one of these online portals. The ERM
application is available at no additional charge.
• Electronic notifications of overpayments – You have the option to replace
paper requests for claim refunds (RFCRs) you receive today with a daily or
weekly e-mail summarizing overpayment requests for each NPI. This will
help reduce the cost of maintaining overpayment records.
• View overpayment requests – You have the ability to view and search/
filter all New, Outstanding, and Closed refund requests that contain an
NPI related to your provider/facility. You can view more details for
each request, including claim, patient account number, service dates,
overpayment reason, etc. ERM gives you a real-time transactional history
for each refund request, showing a complete audit trail for tracking when
an action was taken on a particular item and who performed it (including
closed requests).
• Inquire/Dispute/Appeal the requests – If you have any disagreements
or if would like more information for each request, you can submit your
request online.
• Deduct from future payment – You can settle your overpayment request
by letting BCBSIL deduct the dollars from a future claim payment. You
will still see the information on your PCS or EPS, and you can also see
the details in the ERM transaction history to assist with all
recoupment reconciliations.
• Pay by check – You may select one or multiple requests and refund
BCBSIL by sending us a check. You will be asked to include a system
generated remittance form showing the detail of your refund (generated
within ERM). When BCBSIL receives your refund check you will see
the check number that you sent to settle your overpayment.
• Submitting unsolicited refunds – If you identify a credit balance, you can
submit it online and refund your payment by check, or we can deduct
the refund from a future claim payment. No other contact (e.g., phone
inquiry) is necessary for the credit balance/overpayment situations.
• Alerts – You will receive notification via ERM system alerts in certain
situations, such as if BCBSIL responds to your inquiry or if a claim
check has been stopped.
How do I gain access to the online on-boarding formfor ERM?Availity Users – Click on the HCSC Refund Management link under the
“Claims Management” tab. If you are unable to access this link, please contact
your Primary Access Administrator (PAA). If you do not know who your
Primary Access Administrator is, click on Who controls my access? You may also
contact Availity Client Services at (800) AVAILITY (282-4548) for assistance,
or visit the Availity Web site at www.availity.com for more information.
RealMed Users – Click on the HCSC Refund Management link under the
“Administration” tab. If you are unable to access this link, consult with your
RealMed Customer Account Manager, contact the RealMed Customer Service
Center at (877) REALMED (732-5633), or visit the RealMed Web site at
www.realmed.com for more information.
For further information and updates on ERM and other BCBSIL initiatives,
please continue to visit the "What's New" section of our Provider Web site at
www.bcbsil.com.
*NOTE: If you are not currently registered for Avality or RealMed, you cansign up at any time. Additional information and links to the Availity andRealMed Web sites are available in the Electronic Commerce section of our Provider Web site at www.bcbsil.com.
RealMed® is a registered trademark of RealMed Corporation.
Workshop Schedule
3 July 2009
Upcoming workshops include:
Register today! Visit our Web site at www.bcbsil.com/provider/training.htm
to view the agenda and sign up.
We welcome your participation and value your input. E-mail us at provider_relations@bcbsil.com.
Workshop Date LocationeSolutions July 22, 2009 Advocate Trinity Hospital, Chicago, IL
Summer HMO Forum Aug. 12, 2009 Live Webinar
BCBSIL Uses FACEBOOK for Breaking NewsIn an effort to provide instant
access to information and enhance
the customer service experience
when it counts the most, BCBSIL
has employed another online
media tool – Facebook. This
online interactive social tool will
allow individuals to ask questions,
engage in discussions with other
consumers and get details about
events we sponsor or host. Since
Facebook is updated in real time,
changes, new information and
new topics are added immediately
and often in most cases, improving
our ability to respond during
urgent situations.
Our current Facebook page
contains information about
H1N1 (swine) flu, the COBRA
subsidy and other topics of
interest to consumers.
We invite you and your patients to “become a fan” of our Facebook page. If you are not
already a user, you will need to register. It’s free to subscribe. To access the BCBSIL Facebook
page, go to: www.facebook.com/pages/BlueCross-BlueShield-of-Illinois/71617617946.
Facebook is an independent third party vendor, and BCBSIL has no ownership control over Facebook. BCBSIL makes no representations and warranties regarding Facebook, or any content posted on Facebook. Facebook and/or its users,
are solely responsible for the contents posted on Facebook.
Multi-surgery PricingMethodology to Change Oct. 1, 2009Effective Oct. 1, 2009, BCBSIL will be changing our
methodology for Multi-surgery Pricing (MSP). In
order to be consistent with the health care industry
standard, we will be reimbursing for Operative
Session rather than Operative Area. In many
instances, BCBSIL will allow 100 percent of the fee
schedule for the primary procedure and 50 percent
for both related and unrelated subsequent surgeries
performed on the same day. There is no limit to
the number of susequent surgeries that have to
be performed.
Please contact our Provider Telecommunications
Center (PTC) at (800) 972-8088 if you have
any questions.
New Account Groups
Group Name: Gateway FoundationGroup Number: 097364Alpha Prefix: XOFProduct Type: PPO(Portable)Effective Date: July 1, 2009BC BS
Group Name: Telephone and Data SystemsGroup Number: 109601Alpha Prefix: TDAProduct Type: PPO(Portable)Effective Date: July 1, 2009BC BS
Group Name: The Walsh GroupGroup Number: 992189Alpha Prefix: WCCProduct Type: PPO(Portable)Effective Date: May 1, 2009BC BS
NOTE: The information noted above is current as of the date ofpublication; however, BCBSIL reserves the right to amend thisinformation at any time without notice. The fact that a group isincluded on this list is not a guarantee of payment or that anyindividuals employed by any of the listed groups, or theirdependents, will be eligible for benefits. Benefit coverage issubject to the terms and conditions set forth in the member’scertificate of coverage.
Pre-service Process Reminders
Visit our Web site at www.bcbsil.com/provider 4
Pre-certification and Predetermination Guidelines
In addition to checking eligibility and benefits and consulting approved BCBSIL Medical Policies,
there may be other steps you need to take when considering treatment for BCBSIL members.
Below is a summary of additional procedures that are required or recommended by BCBSIL.
Pre-certification (also known as prenotification or preauthorization) is confirmation that
a physician’s plan of treatment – or other service or treatment – meets the criteria of medical
necessity under the applicable health benefit plan.
When is it required?Most PPO and POS contracts require the member or provider to contact BCBSIL to receive prior
approval for inpatient hospital admissions, including acute, inpatient rehab, skilled nursing,
long-term acute care, inpatient hospice (some groups), and coordinated health care such as
skilled nursing visits, IV medication, etc. (most groups). Pre-certification also may be required
for outpatient services for some employer groups.
You may pre-certify on behalf of PPO and POS members. You MUST pre-certify for
Community Participating Option (CPO), BlueAdvantage/BlueAdvantage Entrepreneur (BAE),
Blue Print (BP), BlueChoice Select and FEP members.* For HMO members, the HMO
Primary Care Physician (PCP) MUST notify the member’s Independent Physician Association
(IPA) of inpatient hospital admissions. (*See additional information regarding FEP member
pre-certifications below.)
How do I complete the pre-certification process?The best way to complete the pre-certification process is to call the number on the back of the
member’s ID card. If you do not have access to the member’s ID card, you may call our Provider
Telecommunications Center (PTC) at (800) 972-8088 to be transferred to the appropriate
area. Online pre-certification for inpatient services also is available via our iEXCHANGE tool.
For details and to sign up for iEXCHANGE, visit the Electronic Commerce section of our
Provider Web site at www.bcbsil.com/provider.
NOTE: There is a separate number on the back of the member’s ID card for pre-certification of mental health admissions and chemical dependency services.
Newborn Pre-certification ReminderPlease remember to notify BCBSIL when a newborn remains hospitalized after the mother is
discharged. You are required to call the number located on the back of the member’s ID card
to obtain pre-certification for any services rendered to the newborn.
It is always important to verify member eligibility andbenefits prior to administering treatment for aBCBSIL member. It is also recommended that youconsult BCBSIL Medical Policy to help ensure thatservices will be eligible for benefits, especially when aprocedure may considered experimental, investigativeor cosmetic. These steps are essential because, in theevent that the services may not be covered, it is yourresponsibility to notify the member that they may bebilled directly.
You may verify eligibility and obtain basicbenefit information for BCBSIL members via the following channels:
• Availity Provider Portal – www.availity.com
• NDAS (eCare®) Online* – www.nebo.com
• RealMed – https://claims.realmed.com
• BCBSIL Provider Telecommunications
Center (PTC) – (800) 972-8088
Prior to utilizing Availity, NDAS Online orRealMed, you must first register directly with these vendors. Additional information and links tothe vendor Web sites are available in the ElectronicCommerce section of our Provider Web site.
To view all approved BCBSIL Medical Policies,please visit our Web site at www.bcbsil.com/provider.These Medical Policies serve as guidelines forhealth care benefit coverage decisions, which may vary according to the different products and benefit plans offered by BCBSIL.
*NOTE: Nebo Systems offers the NDAS Online product to
independently contracted BCBSIL providers. Recently, NeboSystems was acquired by Passport Health Communications, Inc.Currently, there is a nominal charge per transaction for some ofthe online services available through this vendor. Please contactPassport Health Communications at (866) 810-0000 if you have
questions or need additional information.
eCare® is the federal trademark of Nebo Systems.
Federal Employee Program (FEP) Members Pre-certification and Predetermination Exceptions and Requirements
Pre-certification: When rendering services to FEP members, you must call the local Blue Cross and
Blue Shield plan where services are being rendered for pre-certification, regardless
of the state in which the member is insured.
5 July 2009
BlueCard® Tip: Pre-certification Requirementsfor Blue Plan Members It is important to obtain pre-certification of elective
inpatient admissions and some outpatient services
before services are rendered for out-of-area Blue Plan
members. While terminology among the various Blue
Plans may differ, the pre-certification, preadmission
review, preadmission certification or preauthorization
process typically involves a standardized review of the
proposed treatment plan, to determine if the service
or treatment meets the criteria of medical necessity
under the patient’s benefit plan.
Pre-certification must be obtained for all services
and dates submitted on the claim in order to
avoid requests for additional information, claim
processing delays or denials. Here are some
additional guidelines to help promote smooth
and timely out-of-area claims processing:
1. Contact the member's Blue Plan for pre-certification using the telephone number listed
located on the back of the member’s ID card. You
may also obtain pre-certification when calling the
BlueCard Eligibility line at (800) 676-BLUE (2583)*
to verify the member’s eligibility and benefits.
2. Contact the member's Blue Plan with updatedclinical information, if there is a change in the
patient’s status or when an extension of the
number of approved days/services is required.
3. Adhere to the member's Blue Plan guidelines,
when you are responsible for pre-certification,
including situations when extensions of stay or
follow-up calls are required.
*NOTE: If you need help navigating the Interactive
Voice Response (IVR) system, visit the BlueCard
Program section of our Web site for a complete
library of Out-of-state IVR Caller Guides.
For additional information, refer to the
BlueCard Program Manual on our Web site at:
www.bcbsil.com/PDF/bluecard_program_manual.pdf.
We value your input… Please share your out-of-area member servicing
experiences with us via e-mail at
provider_relations@bcbsil.com.
Predetermination, or Predetermination of Benefits, is a voluntary, written request
for review of treatment or services, including those that may be considered experimental,
investigational or cosmetic. Predetermination of Benefits approvals and denials are usually
based on provisions in our medical policies. A Predetermination of Benefits is not a substitute
for the pre-certification process.
When is it required?Submitting a Predetermination of Benefits request is optional in most cases.
(See additional information below regarding predeterminations for FEP members.)
How do I submit a Predetermination of Benefits request?Requests for review of services must be made using the Predetermination Request Form, available
on our Web site at www.bcbsil.com/provider. This form also may be used to appeal a previously
denied Predetermination of Benefits. The completed form must be faxed to BCBSIL, as indicated
on the form. BCBSIL will notify the provider when the final outcome has been reached.
Radiology Quality Initiative ProgramBCBSIL has partnered with American Imaging Management, Inc. (AIM) for management of
our Radiology Quality Initiative (RQI) Program. An RQI number is required by BCBSIL prior
to performing any of the high-tech, elective, non-emergency diagnostic imaging services listed
below for BCBSIL PPO and BlueChoice Select members:
• CT and CTA scans • Nuclear Cardiology studies
• MRI and MRA scans • PET scans
The RQI program applies to all of the above imaging services when performed in a
physician's office, the outpatient department of a hospital or a freestanding imaging center.
Ordering physicians can obtain, and imaging service providers can confirm, a patient's RQI
number via AIM's Web site at www.americanimaging.net. Additional information about
AIM and the RQI process may be found on our Web site at www.bcbsil.com/provider.
NOTE: If an RQI cannot be issued, you will be directed back to BCBSIL to complete the
predetermination process. The RQI program is not a substitute for the pre-certification process.
Please note that the fact that a guideline is available for any given treatment, or that a service or treatment has been pre-certifiedor predetermined for benefits, or an RQI number has been issued is not a guarantee of payment. Benefits will be determinedonce a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’scertificate of coverage applicable on the date services were rendered.
Example: If a New York FEP member is hospitalized in Illinois – you are required to call
BCBSIL. This is the exception to the normal pre-certification process, as outlined within
the general Pre-certification and Predetermination Guidelines above.
Predetermination of Benefits: A review of the following services is required for FEP members:
• Outpatient/Inpatient surgery for Morbid Obesity
• Outpatient/Inpatient surgical correction of Congenital Anomalies, and
• Outpatient/Inpatient Oral/ Maxillofacial surgical procedures needed to correct
accidental injuries to jaws, cheeks, lips, tongue, roof and floor of mouth
BCBSIL published an article on our Web site at www.bcbsil.com in October
2008, as well as in the December 2008 Blue Review in reference to billing
unclassified drugs/injections under “Not Otherwise Classified (NOC)”
drug/injection codes (e.g., J3490, J3590, etc.) using the National Drug Code
(NDC) number.*
We advised physicians and providers that effective Feb. 1, 2009, BCBSIL would
begin checking NDC numbers against the Current Procedural Terminology
(CPT)/Healthcare Common Procedure Coding System (HCPCS) procedure
codes as published by the American Medical Association (AMA).
In order to properly adjudicate claims and reimburse physicians and providers
for these procedure codes, BCBSIL continues to enhance its capabilities for
NDC processing to reduce underpayments and overpayments to our physicians
and providers. We are currently using average wholesale pricing supplied by
Prime Therapeutics to properly adjudicate unclassified drugs/injections.
It is important that physicians and providers supply the necessary information
for BCBSIL to properly adjudicate and reimburse claims for these procedures.
Our claims processing units may have called your office requesting additional
information regarding these unclassified drugs/injections when billed by your
physicians. This is done in an effort to properly adjudicate the claim without
having to request additional information in writing, which could delay the
processing of the claim.
In an effort to minimize these calls to your office, please be sure to include
the following information on your claims when billing for unlisted
drugs/injections:
• NDC Number
• Drug Name
• Dosage administered (e.g., 5 mg, 10 mg, etc.)
• How the number of units being billed on the claim is being administered
(e.g., 5 mg = 1 unit, 10 mg = 5 units, etc.)
• Strength of drug administered (e.g. 25 mg/ml, 10 mg/10 ml, etc.)
• Single dose vial or Multi-dose vial
*NOTE: An NDC number can only be used for a maximum of two years, after which time it becomes obsolete.
If you have any questions, you
may contact our Provider
Telecommunications Center
(PTC) at (800) 972-8088
for assistance.
Update: Proper Use of ‘Not Otherwise Classified (NOC)’ J-codes
Annual Physician/Practitioner Surveys Watch for these Surveys: We Want to Hear From You!
HMO Primary Care Physicians (PCPs) and randomly selected PPO primary care type and specialist physicians
are receiving 2009 surveys.
The surveys are performed annually to analyze physician satisfaction with activities and to evaluate physician experience with
primary hospital services. The HMO survey includes questions about operational, service and reporting activities that HMO
IPAs and BCBSIL conduct. PCPs that contract with more than one HMO IPA will receive a separate survey for each entity
for which they are contracted. The PPO survey also includes questions about BCBSIL activities.
BCBSIL has consistently maintained the confidentiality of all physicians who respond to the surveys.
A number on the survey identifies the physician to assure that we do not record more than one set
of responses per physician. Aggregate results are reported to BCBSIL operating areas and the
HMO IPAs without identification of individual physicians.
The survey questions are addressed directly to the physicians. However, physicians may have office
staff more familiar with some activities. Physicians are encouraged to obtain assistance from
their office staff to complete the survey. Some questions may not apply to the experience of the
physician or their office staff. “No experience” is always an acceptable response when it applies.
Please return all completed surveys in the postage-paid envelope within 10 business days of receipt.
Visit our Web site at www.bcbsil.com/provider 6
7 July 2009
New Electronic CommerceInformational ResourcesHere's an easy way to learn more about ElectronicFunds Transfer (EFT), Electronic Remittance Advice(ERA) and Electronic Payment Summary (EPS)
BCBSIL offers EFT, ERA and EPS to help increase
administrative efficiencies and reduce paper in your
office. Taking advantage of all three of these electronic
options together can help you synchronize your
payment and reporting processes, among other benefits.
We invite you to view our new EFT, ERA and EPSFrequently Asked Questions to find answers to
questions and concerns we hear most often from
providers. Just click on Electronic Funds Transfer (EFT) /
Electronic Remittance Advice (ERA) in the Electronic
Commerce section of our Provider Web site at
www.bcbsil.com to view the new FAQs and find out how
easy it is to participate in these paperless transactions.
You may also contact the Electronic Commerce Center
at (800) 746-4614 if you need additional assistance.
Watch for These Claim Number SequenceChanges on Your Electronic Claim TransactionsEach claim that we receive is assigned a claim number which allows us to track and manage
inventory as a claim is processed. Effective June 29, 2009, BCBSIL has enhanced the claim
number sequence for claims that have an “X” at the end of the claim number. You will see this
new claim number sequence on your Provider Claim Summary (PCS), Electronic Payment
Summary (EPS) and Electronic Remittance Advice (ERA), ANSI X12 835. If you are currently
receiving a Daily Payer Report (DPR), you will see the new claim number sequence on this
report as well.
What will the new number sequence look like?Previously, our claims were assigned a 17-digit number. Going forward, claim number
assignments will contain a combination of 17 alpha and numeric digits. The alpha character
will appear within the 11th through 15th positions of the number sequence. Letters such as
“I” and “O” will not be used since they look similar to numbers.
Here are some examples to give you an idea of how the new claim number will appear:
PCS/EPS Old Claim Number Sequence:0000123456789100X
PCS/EPS New Claim Number Sequence:0000123456A89100X
ERA/835 Old Claim Number Sequence:CLP*607223XX001B*1*14473.55*5746.88*100*15*0000123456789100X**1**065
ERA/835 New Claim Number Sequence:CLP*607223XX001B*1*14473.55*5746.88*100*15*0000123456A89100X**1**065
Currently, you may only see a few claims that have been enhanced with the new claim number.
By the end of 2009, the new claim number sequence will appear on all BCBSIL claims.
Update on ‘Michelle’s Law’ Dependent Student Medical Leave Certification Form Now Available Online
In compliance with Michelle's Law, BCBSIL has made available the Dependent Student
Medical Leave Certification Form in the Provider Library section of our Web site at
www.bcbsil.com/provider/forms.htm. Members are required to use this form to request
a medical leave of absence for a dependent.
The attending physician must also complete a section of the certification form, and provide
the following information:
• Confirmation that the student suffers from a serious illness or injury, and verification
that leave of absence is medically necessary
• Explanation of student’s medical condition
• Timeframe for medical leave
• Signature of attending physician
Completed and signed forms can be mailed to:
Blue Cross and Blue Shield of Illinois, PO BOX 805107, Chicago, IL 60680-4112.
In summary, Michelle's Law (Public Law No: 110-381) allows college students insured under
their parents’ policies to remain covered if they are required to take a medical leave of absence
from school, or make any other enrollment changes that might cause them to lose dependent
student eligibility.
Following the medical leave, student dependents will once again be required to provide
student certification in order to remain eligible for dependent coverage.
This form should be used only for student medical leaves covered under "Michelle's Law,"and student medical leaves covered under Illinois Public Act 095-0958.
In an effort to comply with Fairness in Contracting
Legislation and keep our independently contracted
providers informed, BCBSIL has designated a
column in the Blue Review to notify you of any
changes to the physician fee schedules. Be sure to
review this area each month.
Effective June 15, 2009, codes 90378, P9603 andP9604 were updated.
Annual and quarterly fee schedule updates can be
requested by downloading the Fee Schedule Request
Form at www.bcbsil.com/provider/ forms.htm.
Specific code changes that are listed above can also be
obtained by downloading the Fee Schedule Request
Form and specifically requesting the updates on the
codes listed in the Blue Review.
Fairness in Contracting
The Choice is Yours...Did you know you can opt out of receiving a paper provider newsletter in the mail? It’s easy –just visit the Provider Home page on our Web site at www.bcbsil.com. Click on the “PickPaperless” icon to gain access to a convenient online form you can use to share your e-mailaddress with us.*
We welcome you to consider receiving your Blue Review via e-mail in order to gain quickeraccess to BCBSIL information each month. Electronic delivery also may make distributioneasier – just forward the newsletter to your staff via e-mail,rather than making copies.
If you would prefer to continue receiving a papernewsletter, there is nothing you need to do. Unlesswe receive your request to turn off the paper, youwill continue to receive your Blue Review in themail as you do currently.
*NOTE: Blue Cross andBlue Shield of Illinois isaware of your privacyconcerns. We will makeevery effort to ensure thatyour e-mail address ismaintained in a secureenvironment and held in the strictest confidence.
Blue Review is a monthly newsletter published for Institutional and ProfessionalProviders contracting with Blue Cross andBlue Shield of Illinois. We encourage you toshare the content of this newsletter with yourstaff. Blue Review is located on our Web site atwww.bcbsil.com/provider.
The editors and staff of Blue Review welcomeletters to the editor. Address letters to:
Blue ReviewBlue Cross and Blue Shield of Illinois300 E. Randolph Street – 25th FloorChicago, Illinois 60601-5099E-mail: bluereview@bcbsil.com
Web site: www.bcbsil.com/provider.
Publisher:Stephen Hamman, VP, Network Management
Editor:Gail Larsen, DVP, Provider Relations
Managing Editor:Jeanne Trumbo, Sr. Manager
Editorial Staff:Margaret O’Toole, Marsha Tallerico and Allene WalkerBCBSIL makes no endorsement, representations or warrantiesregarding any products or services offered by independentthird party vendors mentioned in this newsletter. The vendorsare solely responsible for the products or services offered bythem. If you have any questions regarding any of the productsor services mentioned in this periodical, you should contactthe vendor directly.
PRSRT STDU.S. POSTAGEPAIDPERMIT NO. 581CHICAGO, IL
00014.0709 A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
10%
Certno.SCS-COC-001528
top related