Reimbursement Policy Disclaimer
This Policy is intended only for physicians and
other health care professionals. By clicking “I
Accept” below, you acknowledge your understanding
and agreement with the following:
Description:
- The Regence Reimbursement Policy Manual documents
payment methodology for medical and surgical
services. THIS REIMBURSEMENT POLICY DOES NOT
APPLY TO ANY OTHER COMPANY.
Use:
- Reimbursement Policy is used by Regence to
provide consistent and predictable claims payment.
Conflict With Other Documents:
- Reimbursement Policy facilitates the systematic
application of Regence subscriber contracts,
provider contracts, and medical policies. These
documents will govern in the event of a conflict
with the Reimbursement Policy.
Restrictions And Limitations:
- Reimbursement Policy is interpreted and applied
in the sole discretion of Regence.
- Reimbursement Policy does not determine the
schedule of benefits. Rather, Reimbursement Policy
supports the schedule of benefits by establishing
payment rules, coding hierarchy and related processing
systems’ edits. To the extent there are
situations not documented in the Reimbursement
Policy, coding software guidelines control.
- Reimbursement Policy does not dictate to other
BlueCross BlueShield plans how to set allowables
for their providers under BlueCard plans.
- Reimbursement Policy does not constitute medical
advice and DOES NOT guarantee any results or
outcomes.
- Reimbursement Policy is the property of Regence
and you are strictly prohibited from using it
for any commercial use whatsoever. Commercial
use does not include use of the Reimbursement
Policy related to benefit payment for health
care services received by a Regence member.
- Current Procedural Terminology (CPT™)
codes and descriptions are the property of the
American Medical Association with all rights
reserved. You are strictly prohibited from using
CPT™ codes for any unauthorized use whatsoever.
- Every effort is made to update the Reimbursement
Policy in a timely manner. However, there is
no obligation to update this site and the Reimbursement
Policy displayed may be out of date.
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