February 2012
Welcome to The Connection Online
This publication contains important information, including updates to policies and procedures, for physicians, dentists, other health care professionals, facilities and their staff.
If you haven't already, please subscribe to receive email notifications when new editions are available.
Provider Center—Your first contact for member eligibility, benefits and claims information
Beginning March 1, we will require providers to access the Provider Center to locate information regarding eligibility, benefits and simple claims status.
Medical multi-year accumulators now available
The Provider Center now displays medical multi-year accumulators that are applicable to each member’s product.
News and Updates
- View all of our recent updates in the What's New section of our website.
- View Availity’s HIPAA 5010 Frequently Asked Questions, including a list of common error messages and how to resolve them.
Administrative and Billing updates
- Clinical practice guidelines updated
- Credentialing reminder
- Medical record documentation requirements
- Pre-authorization List update
- Submit claims for 2011 dates of service
Medicare
- HEDIS® medical record review coming for Washington Medicare members
- ZIP+4 code required for Asuris TruAdvantage claims
Networks
Policies
Changes to our medical policies are listed below. Learn how policies are reviewed. Our Coding Toolkit includes codes that require clinical information (updated monthly), a complete list of code groupings and our Correct Code Editor (updated quarterly).
Medical
Reimbursement
Medication
Learn how obsolete medication codes are reviewed on a quarterly basis.
Summaries of past changes and detailed policies are available in our Medication Policy Manual at http://blue.regence.com/policy/medication/
View our group and Individual products Preferred Medication List/Formulary.
Search the Asuris TruAdvantage + Rx and Medicare Part D formulary.