Issue 3, 2009
Special coverage for H1N1 vaccine
The BCBSTX policy concerning coverage of charges for administering the H1N1 vaccine to members.
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BCBSTX offers replacement coverage to UniCare members
As part of UniCare’s exit from the Texas market, BCBSTX will offer UniCare members continued coverage with closely matched benefits.
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More than health care, Seasons of Life program is health caring
Seasons of Life for Physicians is a special pilot program designed to help physicians’ office staffs and family representatives with the closing of a practice.
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Paperless transactions are gaining popularity
Enroll in our Electronic Funds Transfer (EFT), Electronic Remittance Advice (ERA) and Electronic Payment Summary (EPS) programs.
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Say goodbye to your paper provider claim summary
With the Electronic Payment Summary (EPS), you receive your payment information sooner, and it is also easier to archive.
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Medicare Advantage mandatory provider FWA training
All contracting providers participating in a Medicare Advantage (Part C) network must complete fraud waste and abuse (FWA) training annually.
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Coordination of benefits
Understanding the coordination of benefits clause from the contracting perspective.
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BlueEdge product portfolio
Get accurate and quick processing of BlueEdge and BlueEdge Direct member claims.
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Life Time Fitness
The BlueExtrasSM program benefit with Life Time Fitness offers a free health screening and a $0 enrollment fee.
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Blue Care Connection® program for tobacco cessation
The Blue Care Connection program for smoking cessation entails working with a wellness coach.
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Weight loss and stop smoking wellness tools for individual members
Two new online wellness tools give specific educational information on smoking cessation and weight management.
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Taxonomy codes — definition and claims use
Taxonomy codes are administrative codes for identifying the provider type and area of specialization for health care providers.
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Claim appeal/reconsideration review process
What’s the process for a claim appeal/reconsideration review?
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Medicare Part D pharmacy updates
The FDA takes action to ensure the safe use of propoxyphene-containing products.
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Medicare-related claims for BlueCard members
How to file your BlueCard Medicare-related claims properly.
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Crossover process saves time and money for Medicare Part A & B
electronic claims
The Blue Cross and Blue Shield of Texas (BCBSTX) Defensive Strategy Medicare Part A & B team has implemented an electronic submission process.
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EDS collaborates with Express Scripts
The EDS Health Advocate Program combines elements of traditional health care management with a health coaching component.
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Fee schedule updates effective in August
ParPlan, BlueChoice® and HMO Blue® Texas maximum allowable fees were updated to reflect 2009 relative values as of Aug. 15, 2009.
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News and announcements
Each issue, we publish brief notices and announcements you may need. For the latest updates, visit the What’s New section of our Provider Web site at http://www.bcbstx.com/provider.
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Contact us
Click here for a quick directory of contacts at BCBSTX. Change your information online
Click the Change Your Information icon at www.bcbstx.com/provider to electronically submit a change to your name, office or payee address, e-mail address, telephone number, tax ID, or other information. You should submit all changes at least 30 days in advance of the effective date of the change.
If your specialty, practice information/status or board certification is not correct on Blue Cross and Blue Shield of Texas (BCBSTX) Provider Finder®, or if you would like to have a subspecialty added, you can enter the information in the Other field or contact your local Professional Provider Network office.
Blue Review is published for BlueChoice®, ParPlan and HMO Blue® Texas contracting physicians and other health care providers. Ideas for articles and letters to the editor are welcome; e-mail BlueReviewEditor@bcbstx.com.
The information provided in Blue Review does not constitute a summary of benefits, and all benefit information should be confirmed or determined by calling the customer service telephone number listed on the back of the member ID card.
BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by independent third-party vendors mentioned in this newsletter. The vendors are solely responsible for the products or services they offer. If you have any questions regarding any of the products or services mentioned in this periodical, you should contact the vendor directly.
