This publication contains important information, including updates to policies and procedures, for physicians, dentists, other health care and dental professionals, facilities and their staff.
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Quickly find patient eligibility and benefit information online using our Provider Center. Customer Service can help answer complex inquiries and provide information that you cannot find online. In addition to offering your office training on our online tools and paperless options, our Provider Relations staff can support your office by answering inquiries not found using the Provider Center or by contacting Customer Service.
We hope this article makes it easier for you to quickly find the answers you need.
We recently announced upcoming RQI program changes for our group and Individual products.
Effective with dates of service on or after September 1, if an order number has not been obtained for specific advanced imaging tests from AIM prior to performing the procedure, it will be denied as a provider write-off. This requirement applies to members enrolled on the following products:
You may be an emergency room (ER) alternative, if you:
Members can now quickly view which providers are ER alternatives when searching on myAsuris.com. The Provider Search feature automatically highlights clinics contracted with us as urgent care centers or retail clinics.
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).
Medical
Reimbursement
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 at http://blue.regence.com/policy/medication/
View our group and Individual products Preferred Medication List/Formulary.
Search the Asuris TruAdvantage + Rx and Medicare Part D formulary.