June 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.
Editions are published in February, April, June, August, October and December.
If you haven't already, please subscribe to receive email notifications when new editions are available.
Save time, money and paper—use electronic transactions
If you are not submitting claims and attachments electronically and receiving payments and vouchers electronically, we strongly urge you to consider doing so.
- Electronic claims are processed more quickly.
- Electronic attachments eliminate lost documents and reduce the number of requests sent for the same information.
- Electronic vouchers and funds transfer allow you to receive your payment sooner and have it posted automatically to your accounts.
Health Care Reform
News and Updates
- View all of our recent updates in the What's New section of our website.
Administrative and Billing
- Administrative Manual update
- Changes to coverage for maximum safe and effective medication doses
- Conflict of Interest statement will be required during credentialing and re-credentialing
- National Drug Codes (NDCs) required for medications
- Pre-authorization lists updated
- Submit Asuris TruAdvantage™ claims for 2010 dates of service
- Use of a member consent form
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).
Medical
Reimbursement
- Asuris TruAdvantage "not payable" codes for hospitals
- HCPCS Q0091, G0101–G0102, and S0610–S0612 code use
- Outpatient group physical therapy reminder
- Same day edits added to CPT 92511
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.