The Connection OnlineSM
October 2011
Welcome to The Connection Online
This publication contains important information, including updates to policies and procedures, for physicians, dentists, other health care and dental professionals, facilities and their staff.
If you haven't already, please subscribe to receive email notifications when new editions are available.
Register now for a provider workshop near you
It's not too late to register for one of our upcoming provider workhops.
Join us at a location near you:
- Salt Lake City: Tuesday, October 4 (9 a.m. - 3 p.m.)
- Ogden: Wednesday, October 5 (9 a.m. - 2:30 p.m.)
- Provo: Thursday, October 6 (9 a.m. - 11:45 a.m.)
New medical director joins Regence this month
Regence BlueCross BlueShield of Utah welcomes Dr. Michael Kaufman as our new medical director. He is a graduate of Columbia College, received his Juris Doctor degree from Harvard Law School and a Doctor of Medicine from Yale. Dr. Kaufman completed his pediatric residency at Pittsburgh Children’s Hospital and a Health Policy Fellowship at RAND.
Dr. Kaufman has executive level experience in medical group practice, health plan administration and health law. He has consulted on health care reform, cost management and delivery system care coordination.
Dr. Kaufman will join Regence on October 10.
New provider network and medical products coming in January
In January, we will introduce a new provider network. In addition, we will offer several new Individual and group medical products.
News and Updates
- View all of our recent updates in the What's New section of our website.
Administrative and Billing updates
- Administrative Manual updates
- Average wholesale price (AWP) primary source change as of September 28
- Clinical practice guidelines updated
- Electronic Data Interchange (EDI) news and updates
- HIPAA 5010 address requirements
- ICD-10 and available resources
- Organizational credentialing reminder
- Pre-authorization lists revised
- Submit claims attachments electronically
- Taxonomy code requirement effective in January
Medicare
Products and Programs
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).
New clinical editing software to launch first quarter of 2012
Medical
Reimbursement
Dental
View our Dental Policy Manual.
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.
View our group and Individual products Preferred Medication List/Formulary.
Search the Regence MedAdvantage + Rx and Medicare Part D formulary.