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Administrative Manual

Our manual contains dental and medical policy and procedure information that can be used as a day-to-day reference by our providers and their staff.

Notification of content changes
Updates to manual sections are posted at the beginning of the month in which they occur and a notification is included in our newsletter, The Connection OnlineSM. Our newsletter is published in February, April, June, August, October and December. Sign up to receive our newsletters via email. Please review new content promptly to ensure you have the most current information.

Learn more about Regence, view our Code of Business Conduct policy or our Confidentiality information and requirements.

Manual
Section Change
Revision Date
Appeals Updated the dental appeals information to reflect that dental appeals follow the process for medical appeals
2/2012
Behavioral Health Updated the Milliman Care Guidelines information
12/2011

BlueCard® Program

 Converted to Web-based format
5/2010
Care Management Added information about our Integrated Care Management program
1/2012
Credentialing

Converted to Web-based format
7/2010
Facility Guidelines
•

New hospital section
• Preferred Hemophilia network criteria (effective 7/15/11)
Effective 8/2011

Federal Employee Program (FEP)

Added 2012 benefit information 1/2012
Filing Claims Converted to Web-based format
11/2010

Fraud and Abuse

Converted to Web-based format
4/2010
Identifying Members Updated the information about what is displayed on the standard and Regence MedAdvantage member cards
1/2012
Medicare Advantage Plans

Updated benefit information for 2012
1/2012
Payment (PDF)

Added information about redesigned Regence MedAdvantage vouchers
1/2011
Quality Program Converted to Web-based format
2/2010
Regence Life and Health Dental Products (PDF) Updated contact information
12/2011

Regence Policies

  • Dental
  • Medical
  • Medication
  • Reimbursement
 Section renamed. Dental policy information added. 8/2011

RegenceRx®  Provider Basics

 Converted to Web-based format
5/2010

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