Is your listing in our Provider Directory correct?

Please help us maintain the accuracy of our Provider Directories by using the Provider Information Update Form or contacting provider services when you have any of the following changes to your practice:

• A physician or other health care professional joins your clinic
• A provider leaves your clinic
• Your clinic/practice is no longer in business
• Change of address, phone number, tax ID or NPI number

11/11/2009

ProClaimWin is transitioning to Internet connectivity

Effective January 1, 2009, dial-up modems will no longer connect to ProClaimWin. Take time now to make this important change and download the latest version of ProClaimWin.

Electronic transactions, such as claim submission, eligibility requests, and claim status can now be sent to Regence through your Internet connection rather than your dial-up modem. 

Benefits include:

• Faster response time
• Less cost than using a dial-up modem
• Free electronic transmission through our newest version of ProClaimWin software

Your current Utah Health Information Network (UHIN) membership applies to this new version.

If you submit to out-of-state payers (such as Cigna, Aetna, etc.), you need to subscribe to a clearinghouse option offered through UHIN. Emdeon^® and Capario^SM are clearinghouses that support UHIN transactions outside the state of Utah.

Learn more about the latest version of ProClaimWin and download it today.

10/30/2009

Join the Regence Online Network Panel

Regence Online Network Panel gives clinic administrators and office managers the opportunity to participate in surveys and forums about various health issues, trends and initiatives that are important to the community and Regence. If you are interested in joining the panel, please send an email that includes your name, title, office or practice name, and phone number to ronp_support@regence.com.

10/30/2009

Important Data Security Notice

Regence's business partner, the Blue Cross and Blue Shield Association (BCBSA), recently experienced an unauthorized transfer of data to a laptop that was subsequently stolen on August 25.

For Regence participating providers whose Social Security number and tax identification (ID) number are the same, BCBSA is offering one year of free Triple Alert^SM credit monitoring membership from, ConsumerInfo.com Inc. Notifications were sent to providers at risk on October 15.

If you are only contracted for TRICARE this incident does not apply to you and you received the mailing in error. You can disregard that notice as the BCBSA does not have your data on file.

Dental electronic transactions workshop

The Utah Health Information Network (UHIN) is conducting a free workshop for dental professionals on electronic transactions. Learn more about Electronic Data Interchange (EDI) which provides for an even quicker turnaround on your claims. 

Learn more about electronic transactions for dental services.

10/07/2009

New BlueCard^® Provider Customer Service hours

BlueCard Provider Customer Service specialists are now available from 8 a.m. to 4:30 p.m.

09/21/2009

Provider Center Outage Notification

There will be a system upgrade this weekend which will result in limited access to some information. This will only impact patients on our medical products - Regence Innova^®, Engage^®, Activate^SM and HSA Healthplan 2.0^SM; and our dental products - Encore^SM, Radiance^SM and Expressions^SM.

The outage is scheduled to begin at 4 p.m. PDT, on Friday, September 4 and continue through Monday, September 7 ending at 9:00a.m PDT. We apologize in advance for any inconvenience this may cause you.

09/01/2009

Claim Vouchers enhanced

In the next few weeks, you will notice changes to the Claim Vouchers for your Regence Innova^®, Engage^®, Activate^SM, HSA Healthplan 2.0^SM and BlueCard^® patients.

Enhancements to the main voucher pages:

• A Coordination of Benefits Amount column added
• The Interest Paid column moved to a Claim Interest line in the patient-specific claim information
• Adjusted claims that have an amount to be recovered will be listed in a new “Summary of Adjusted Claims to be Recovered” section. Only original claims and adjusted claims that do not have an amount to be recovered will be listed in the main section.

Other enhancements

• All sections include the provider network (Network ID) for each claim.
• Within each section, claims are sorted by network, patient name and claim number.
• After the main voucher pages, the section order will be:

• Payment Summary
• Summary of Payment Reductions
• Summary of Adjusted Claims to be Recovered
• Pended Claims Summary

View our Guide to Claim Vouchers

09/01/2009

Medicare alert to update account information in 48 hours is a scam

The Centers for Medicare & Medicaid Services (CMS) has notified us of a scam where perpetrators are sending faxes to physician offices posing as Medicare carriers or Medicare Administrative Contractors (MAC). The fax instructs staff to respond to a questionnaire to update account information within 48 hours in order to prevent Medicare payment gaps. The fax may have the CMS logo and/or the contractor logo to enhance the appearance of authenticity.

If you receive a request for information that seems suspicious, please check with your contractor before submitting any information. Medicare providers should only send information to a Medicare contractor using the Provider Call Center Toll-Free Numbers Directory found in the download section of the CMS Web site.

07/21/2009

Regence Launches Consumer Engagement Campaign

With health care reform at the center of debate in D.C. and no clear answers on how to achieve a working system, or reign in runaway health care costs, Regence continues in our efforts to educate and engage consumers in becoming more active participants in the health care system.

To help in this long-term endeavor, early this week Regence launched a newly revamped, interactive www.WhatsTheRealCost.org Web site.

This site is part of our ongoing campaign to educate consumers about the real costs of health care, how the choices they make each day impact those costs, and that without addressing costs, we cannot achieve meaningful transformation of the health care system.

This campaign is geared toward all consumers, as the more interactive site will appeal to a variety of demographics. We encourage you to visit www.WhatsTheRealCost.org and experience the various elements of this Web site designed to help people understand the problems facing our health care system, and to inspire them to take action toward meaningful health care reform.

If you have questions about www.WhatsTheRealCost.org please contact your provider consultant.

07/17/2009

Join the Regence Online Network Panel

Regence Online Network Panel gives clinic administrators and office managers the opportunity to participate in surveys and forums about various health issues, trends and initiatives that are important to the community and Regence. If you are interested in joining the panel, please send an email that includes your name, title, office or practice name, and phone number to ronp_support@regence.com.

06/29/2009

Name change for two Utah provider networks
Regence is changing two of our Utah provider network names to become consistent with the names used by other Regence and Blue Cross and/or Blue Shield Plans. Network names will change as shown below:

Our member and provider communications will be updated to reference Participating (Traditional) and Preferred (ValueCare) networks as we transition to the new names.

Adopting the same naming conventions as other “Blue” Plans makes it easier to receive benefit or eligibility information for your patients with coverage outside of Utah.

For questions, please contact your provider consultant, or Provider Services
at 1 (800) 621-2155 Option 6, Option 2.

04/13/2009

Medicare compliance training required for Regence MedAdvantage providers

Effective January 1, 2009, new Centers for Medicare & Medicaid Services (CMS) regulations require compliance training for “first tier, downstream and related entities” of a Medicare Advantage plan. Physicians and other health care professionals who contract with a Medicare Advantage plan, such as Regence MedAdvantage, are considered “first tier” entities. This designation applies not only to Regence MedAdvantage, but to any Medicare Advantage plan with which you contract.

We have developed an online workshop that meets the CMS requirement. Training developed internally or by third parties may also be used. Training must be completed yearly and documented.

It takes approximately 20 minutes to complete the online workshop.

01/27/2009