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.
| Manual |
| Section |
Change |
Revision
Date |
| Appeals |
| • |
Updated the up-front filing fee for second level external provider appeals to $50 |
| • |
The separate Dental appeals process was removed as these appeals now follow the same process as other professional providers |
| • |
Removed references to investigational from the Provider Billing Dispute and Medical Necessity Procedure Determination Appeal Process |
|
5/2012 |
| 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 |
Added ICD-10 information, other billing information and an updated dental billing link |
3/2012 |
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 |
Added information about Physician Quality Measurement (PQM) and Blue Physician Recognition (BPR) Programs |
4/2012 |
| 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 |
|
