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Administrative Manual


Section
Change
Revision Date
Introduction (PDF) Minor text changes including where to find Contact information
11/2009
Who to Contact

Information moved to Contact Us and other sections of our Web Site
11/2009
Provider Agreements Information moved to other sections of our Administrative Manual
2/2010
Credentialing (PDF) Revised Practice Site Review Standards
11/2008
Identifying Members (PDF)

Added Regence EvolveSM Individual and Family product member cards
3/2010
Filing Claims (PDF) Removed information on resubmission of tracer claims and updated information about filing claims electronically
2/2010
Payment (PDF) Added information regarding Regence Evolve Individual and Family products vouchers
3/2010
Appeals (PDF)

Added external reviewer timeframe for billing disputes and updated member appeal information
12/2009
Fraud and Abuse (PDF) Expanded section to include topics related to preventing fraud, External Audit, Federal False Claims Act and member card fraud
11/2009
Medical and Reimbursement Policy Converted to Web-based format
2/2010
Care Management (PDF)  
11/2007
Quality Program Converted to Web-based format
2/2010
Behavioral Health Converted to Web-based format
3/2010
Provider Center
(formerly known as Regence Online Services for Providers)		 Added information about our new administrative tools
2/2010
RegenceRx® Provider Basics (PDF)  
5/2008
BlueCard® Program (PDF) Added Medicare Private Fee For Service information for out of area Medicare members
5/2009

Product Overview

 Added Regence Evolve Individual and Family products and converted to Web-based format
3/2010

Federal Employee Program (FEP)

Converted to Web-based format. Added new Wellness Program information
1/2010
Medicare Advantage Plans (PDF) Added 2010 benefit summaries, new member card samples and changed appeal language
2/2010
Self-Managed and Consumer Directed Products (PDF)

Added Preferred BlueOption Network information
1/2010
Glossary (PDF) Updated definitions
2/2010

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