blueREVIEWREVIEW · back from our telephone and field rep-resentatives who interact closely with providers. We use this research to ... character alpha prefix If you have questions

BlueCross BlueShieldof Illinois

For Contracting Institutional and Professional Providers

blueREVIEWREVIEWwww.bcbsil.com/provider

September 2005

New Specialties Added to the PPO Network—APN/DME/HITNew Specialties Added to the PPO Network—APN/DME/HITNew Specialties Added to the PPO Network—APN/DME/HITNew Specialties Added to the PPO Network—APN/DME/HITNew Specialties Added to the PPO Network—APN/DME/HITBlue Cross and Blue Shield of Illinois is pleased to announce the addition of the following provider specialties into our

PPO Network of contracting providers:Durable Medical Equipment (DME)Home Infusion Therapy (HIT)Advanced Practice Nurse (APN) - Clinical Nurse Specialists (CNS) and Nurse Practitioners (NP). The other two APNspecialties, Certified Registered Nurse Anesthetists (CRNA) and Certified Nurse Midwives (CNM) are already in the

PPO Network.These provider specialties will be added to the PPO Network, upon group renewal, starting Novem-

ber 1, 2005. All DME, HIT and APN providers who meet the required credentialing criteria may re-quest a PPO contract by submitting an email to [email protected].

Please note: Those APNs that are currently employed by a physician or physicians’ group and do notintend to bill on their own should not apply to participate in the PPO network.

Please reference upcoming editions of the Blue Review for further information regarding group renewaland reimbursement.

Introducing BCBSIL’s...New Designated Centers for Bariatric Surgery

Blue Cross and Blue Shield of Illinois (BCBSIL) is establishing Designated Centers forBariatric Surgery for members whose coverage includes benefits for bariatric surgery.These centers are part of BCBSIL’s firm commitment to managing the issue of obesity. In

addition, informing members about bariatric centers with the highest success rates is expectedto improve health outcomes and financial performance by lowering complication and readmis-sion rates and shortening hospital stays.

The Selection ProcessThe Selection ProcessThe Selection ProcessThe Selection ProcessThe Selection ProcessAll centers who applied completed a Request for Information (RFI) that sought detailed in-

formation about qualifications and experience from each hospital and surgeon along with theirsurgical success rates and complications during the past several years. BCBSIL received 23hospital applicants. A review committee conducted a name-blinded analysis of the RFI results based on defined clinicalcriteria, and ultimately selected six hospitals in Illinois.

In addition, the Blue Cross and Blue Shield Association is currently collecting information from hospitals across thecountry to designate bariatric surgery centers on a national basis. Those designations are expected to be available in 2006.

Designated Centers for Bariatric Surgery and Participating Networks:Designated Centers for Bariatric Surgery and Participating Networks:Designated Centers for Bariatric Surgery and Participating Networks:Designated Centers for Bariatric Surgery and Participating Networks:Designated Centers for Bariatric Surgery and Participating Networks: PPOPPOPPOPPOPPO POSPOSPOSPOSPOS HMOHMOHMOHMOHMO

Alexian Brothers Medical Center—Elk Grove Village X X X

Evanston Northwestern Hospital—Evanston X X X

Northwestern Memorial Hospital—Chicago X

Rush University Medical Center—Chicago X X

Trinity Medical Center—Moline X X

University of Illinois Hospital—Chicago X X X

(Continued on page 6)

2 Visit our Web site at www.bcbsil.com/provider

September Blue Review 2005

Publisher: Phil Lumpkin, VP, Provider AffairsEditor: Carol Pjosek, Director

Managing Editor: Jeanne Trumbo, Senior ManagerProduction & Copy Editors:

Margaret A. O’Toole and Allene Walker

Blue Review is published monthly by:Blue Cross and Blue Shield of Illinois

Operations/Education/Communications Dept.300 E. Randolph Street – 25th Floor

Chicago, IL 60601-5099(312) 653-4019, or fax (312) 938-8021

Blue Review is a monthly newsletter published for Institutional and Professional Providers contracting with Blue Cross and Blue Shield of Illinois. We encourage you to sharethe content of this newsletter with your staff. The Blue Review is located on our Web site at www.bcbsil.com/provider/bluereview.htm and on THIN Online.

Provider Satisfaction Increases with BlueCard® Claims HandlingBlueCardBlueCard

Blue Cross and Blue Shield Plans,independent licensees of theBlue Cross and Blue Shield As-

sociation, are proud of a 76 year his-tory of service in the healthcare indus-try. Because of our relationship withproviders like you, over 90 millionmembers across the nation choose BlueCross and Blue Shield as their healthinsurer. That includes over 6.5 millionBlue Cross and Blue Shield of Illinois(BCBSIL) members and nearly 500,000members of other Blue Plans who re-side in the BCBSIL service area. Tobuild on our successful history, we arefocusing on your needs – by simplify-ing administrative processes and im-proving our service to you.

BCBSIL holds focus groups, reviewssatisfaction surveys and collects feed-back from our telephone and field rep-resentatives who interact closely withproviders. We use this research todeepen our customer focus, improveour service delivery with theBlueCard® Program (out-of-areaclaims) and implement new technol-ogy to meet your changing needs.

Research results for 2004 indicatethat we are improving provider satis-faction with the BlueCard Program.Providers noted significant service de-livery improvements in claims accu-racy and resolution from 2003 to 2004:

Attention All Contracting Providers—Importance of Telephone NumbersOur Provider File requires a valid telephone number for each of your office locations. Your office telephone

number is listed on our BCBSIL Web site and in our directories for the POS and HMO networks, and is used byour members and other providers to contact your office.

Periodically, our file is reviewed for accurate information and if a telephone number is found to be invalid and weare unable to locate a valid number, your office site may be inactivated. This will result in the site being removed fromour Web site and directories.

Please log on to the BCBSIL Web site at www.bcbsil.com and check the telephone number(s) per office listing. If anupdate is needed, a Provider File update form is available for you to complete online and submit to us. In addition,you may mail your corrected information to:

Blue Cross and Blue Shield of IllinoisAttn. Network Operations 25th Fl

300 E Randolph St.Chicago, Illinois 60601

Claims accuracy improved 6%Satisfaction with resolving problemclaims increased 8%Number of claims requiring follow-up decreased 10%.

BCBSIL has the largest number ofnational account members in our ser-vice area, and we are proud to be yoursingle point of contact for claims, pro-vider service and provider educationrelated inquiries.

In 2005, we have committed to fur-ther improve our service to you by:

Continuing to improve claims accu-racy and claim resolutionImproving claims timelinessPromoting internal education to en-sure an excellent provider serviceexperienceConducting focus trainings tostrengthen provider knowledge ofthe BlueCard program

RememberRememberRememberRememberRemember

To check eligibility and benefits onBlueCard (out-of-state) members,please call (800) 676-BLUE (2593)Submit all clams electronically toBCBSIL and include the member’scomplete ID number and the three-character alpha prefixIf you have questions about the

BlueCard program or filing claims forout-of-area patients, please contact ourProvider Telecommunications Center(PTC) at (800) 972-8088.

3


2005 HMO Member Satisfaction SurveyObjectiveObjectiveObjectiveObjectiveObjectiveThe 2005 HMO Member Satisfaction Survey by Medical Group/IPA was conducted in March and April. The primary pur-pose of this survey was to assess member satisfaction with various attributes at the MG/IPA level, including medical careand services rendered by PCPs, specialists, access and overall medical group service. One-hundred forty-three (143) MG/IPAs were analyzed to achieve the overall network results.

Member SelectionMember SelectionMember SelectionMember SelectionMember SelectionThe member sample was determined by a stratified random sample by MG/IPA. The overall response rate for this year was25.8%. The member had to meet the following qualifications in order to be eligible:

18 years of age or olderMember of MG/IPA for at least 12 months based on BCBSIL membership

Survey ResultsSurvey ResultsSurvey ResultsSurvey ResultsSurvey ResultsMG/IPAs that scored less than 80% for the overall member satisfaction score (a composite of 31 questions) in 2005 receiveda request for a written improvement plan. If your MG/IPA did not receive this request, then no written improvement plan isrequired. Highlights of 2005 results are presented in the table below.

Other accolades include satisfaction with the PCP and specialist regarding respect to privacy/attention shown, accuracyof diagnosis, thoroughness of exams, friendliness/courtesy, and medical care received.

Next StepsNext StepsNext StepsNext StepsNext StepsThe next survey will be mailed in March 2006 to randomly selected members. Please feel free to encourage members to com-plete the survey.

Managed Care CornerManaged Care Corner

PCP Managing/Coordinating Member’s Care:

In the past 12 months, did your PCP’s office remind you about getting preventive care that you weredue to receive? (%Yes)How often did your PCP give clear instructions on health problems or symptoms bothering you?(% Always & Usually)How often did your PCP give you as much info about your condition and treatment as you wanted?(% Always & Usually)Did your PCP talk with you about different medicines you are using, including any medicines pre-scribed by specialists? (% Always & Usually)How often did your PCP seem informed and up-to-date about care you received from specialist doc-tors? (% Always & Usually)

Referral Process:

Satisfied with referral process for specialists (% Yes)Did your PCP recommend a referral to a specialist in the last 12 months?If yes, was this referral approved?Average time to obtain approval for a routine referral from your PCP:0 - 2 Calender days3 - 5 Calender days6 - 10 Calender days> 10 Calender days

Accolades

Satisfaction questions on the 2005 survey that scored more than 90%:Overall Satisfaction with MG/IPAOverall Satisfaction with PCPOverall Satisfaction with Specialist

2005

63.2%

82.8%

82.1%

73.3%

78.4%

2005

87.3%89.5%98.7%

50.4%31.9%12.3%5.4%

91.6%91.9%92.2%



RealMed Clients Reap Maximum ValueA tool can only provide value if it is used to its full potential. RealMed is a wed-based, electronic claims submission tool,

but it is much more than that for those clients who choose to maximize its value by utilizing all of its capabilities.When practices do this, they can increase their operational efficiency, gain insight into their business, and maximize theircash flow.

Of course, moving from paper to electronic claim submission can be scary. However, as practices become more familiarwith the new workflow and processes (usually in 2-3 weeks), their efficiency and positive results can improve dramatically.

Part of that workflow change may include checking patients’ eligibility up front to eliminate about two-thirds of thepractices’ claim errors. Eliminating eligibility errors up front not only reduces denial rates, but it also allows billing staff tofocus on exceptions and problems, which reduces follow-upwith payers.

Using RealMed’s Claim Submission and Status Manage-ment features, practices gain visibility and trackingfunctionalities that move them from an information-seekingmode to an action-taking mode. Plus, these tools can be used to provide proof of timely filing.

Automated posting of ERAs give practices increased efficiency with RealMed’s translation of ERA information to theformat required by your practice management system. Because this is done at a “line level” of detail, it is easy to review,and the historical claim information makes comparing it to remittance information easier.

RealMed’s real-time connections with Blue Cross and Blue Shield of Illinois, and several other large payers, help ensureyour claims reach a paid status in 5-10 days. The practice’s increased cash flow means it has more resources to grow thepractice and invest in new equipment or technology.

Practices that work closely with RealMed’s local Customer Account Managers (CAMs) learn other ways to improveclaims processing and systemically reduce error rates, which also helps them achieve maximum value. The averageRealMed client in Illinois, who has been on the service for as little as 15 days, typically reduces its error rates by 15%.Medical group practices that have used the RealMed service longer than one year typically experience a 60% reduction inerror rates.

RealMed has helped many practices enhance their operational efficiency; gain more knowledge and insight; and receivefaster payments from payers and patients. RealMed may be able to help your practice achieve these results too. To speakwith a RealMed representative, call Teresa Luciano at (773) 867-8304.

When filing paper claims, please remember to include your Illinois Blue Shield Provider Number in box 33 on theCMS-1500 form. For individual providers, enter your 8-digit Blue Shield Provider Number after the PIN#. For Group

Providers, enter your 8-digit Blue Shield Provider Number after the GRP#.

Why is it important?Why is it important?Why is it important?Why is it important?Why is it important?Your Blue Shield Provider Number lets us know that we have a valid Illinois license number on file and that you are eligible

to bill for services to BCBSIL. It is also needed to ensure you receive the correct level of reimbursement. If this information is notentered, your payment may be sent to an incorrect provider, to the patient, or the claim may even be rejected and sent back to youfor this additional identification.

If you have lost or forgotten your provider number, you may request this information by submitting a written inquirythat includes your signature (preferably on business letterhead). The request may be faxed to Provider Services at (312) 856-1946 or mailed to:

Attn: Provider Services Unit-27th floorBlue Cross and Blue Shield of Illinois

300 East Randolph St.Chicago, IL 60601

Don’t Forget Your Provider Billing Number

Electronic SolutionsElectronic Solutions

Claims and BillingClaims and Billing

5


Electronic SolutionsElectronic SolutionsUpdate - Medicare CrossoverMedicare Primary, Blue Cross and Blue Shield Secondary Paper ClaimsYou may have already begun to see the following new Provider Claim Summary (PCS) or Electronic Remittance Advice

(ERA) rejection code for paper submitted Medicare Primary, BCBSIL Secondary claims:

PCS rejection code message:PCS rejection code message:PCS rejection code message:PCS rejection code message:PCS rejection code message:“Submitted charges duplicate a verified Medicare Crossover arrangement. If you do not receive payment after 21 days (14-day Medicare payment holding period, plus 3-7 days for BCBS Supplemental claim adjudication) you may resubmit anelectronic claim to BCBSIL. A resubmitted Secondary paper claim must be submitted as a request for review.”

ERA adjustment reason code:ERA adjustment reason code:ERA adjustment reason code:ERA adjustment reason code:ERA adjustment reason code:“B5 = Payment adjusted because coverage/program guidelines were not met or were exceeded”

On July 1, 2005, we began rejecting paper Secondary claims when we have established a verified crossover arrangementfor a member through a positive match with the member’s Medicare Health Insurance Claim Number (HICN). In thosesituations where there is no positive match, we will continue to process Medicare Primary, BlueCross and Blue Shield Secondary claims with existing procedures.

Advantages to CrossoverAdvantages to CrossoverAdvantages to CrossoverAdvantages to CrossoverAdvantages to CrossoverThere are some very good reasons for you to wait for the electronic crossover arrangement withMedicare:

It saves you the time of submitting supplemental claims to us.It saves you the trouble of submitting EOMB attachments. The electronic crossover claim hasthe EOMB information (claim and remittance data) that we need to process supplementalclaims.It will help to reduce the administrative cost incurred when claims are submitted via paper.It will eliminate the 688 rejections and B5 rejections.

Do all claims Crossover?Do all claims Crossover?Do all claims Crossover?Do all claims Crossover?Do all claims Crossover?There are some situations when a claim does not crossover because the member’s Health Insurance Claim Number(HICN) does not match our membership file. We have worked diligently to minimize mismatched files. As a result, youshould see fewer claims that do not crossover. It is only when a claim does not crossover that you need to file an electronicclaim to BCBSIL.

Follow These Steps before Submitting a Supplemental Claim to UsFollow These Steps before Submitting a Supplemental Claim to UsFollow These Steps before Submitting a Supplemental Claim to UsFollow These Steps before Submitting a Supplemental Claim to UsFollow These Steps before Submitting a Supplemental Claim to Us

1. Check to see if the claim automatically crossed over:The Medicare Remittance Advice will contain a message that the claim was forwarded through the crossover process.Crossover claim payments are highlighted with the message, “Medicare Crossover Claim” on the Provider Claim Sum-

mary (PCS) and on the Electronic Remittance Advice (ERA)2. If the claim did not crossover you may submit it electronically. For more information on the electronic submission of profes-

sional Medicare Primary, Blue Cross and Blue Shield Secondary claims you may access the Medicare B SupplementalClaim Submission Reference Guide located at www.bcbsil.com/provider/referenceguide.htm. This reference guide pro-vides the requirements for submitting electronically. Facility providers may access the “Medicare Supplemental UB-92Claims Reference Guide” at the same location for information on submitting electronic facility claims that did not crossover.

3. Do not resubmit a rejected claim by paper; as it will deny as a duplicate. You must submit the rejected claim for review.Please follow the usual review process by either calling the Provider Telecommunications Center (800-972-8088) or send-ing in a Provider Review Form, which is located on the BCBSIL Provider Web site at www.bcbsil.com/provider.

Vendors and Billing Services NotifiedVendors and Billing Services NotifiedVendors and Billing Services NotifiedVendors and Billing Services NotifiedVendors and Billing Services NotifiedThis notification and the specific requirements have already been sent to BCBSIL vendors and billing services. However,

please contact your specific vendor or billing service to verify that they are aware of the new process, and to ensure thatyour Medicare Primary and Blue Cross and Blue Shield Secondary claims can be submitted electronically when they donot crossover.



Account InformationAccount InformationNew Account GroupsGroup Name Group Number Alpha Prefix Product Type Effective Date BlueCross BlueShield

MasterBrand Cabinets, Inc.* 014403-05 MKR PPO(Portable) January 1, 2006 X XTuckpointers 52 P03878** TUK PPO(Portable) July 1, 2005 X XUSF Corporation 010626 FWY PPO(Portable) July 1, 2005 X X**Please note the correct group number for Tuckpointers 52.

Introducing BCBSIL’s New Designated Centers for Bariatric Surgery (cont.)(Continued from page 1)

NetworksNetworks

BA HMO = BlueAdvantage HMOBlueEdgeSM Participating Provider Option (PPO) = Consumer Driven Healthcare Product (CDHP)*BlueChoice Select = Point of ServiceCMM = Comprehensive Major MedicalPOS = Point of Service (BlueChoice)PPO = Participating Provider Option (Hospital and Physician Network)PPO Hospital Network = Participating Provider Option (Hospital Network Only)PPO(Portable) = BlueCard PPOHMOI = Health Maintenance Organization of IllinoisHMOI AFHC = HMOI Away From Home Care

Key:

Professional Reimbursement—Fairness In ContractingFairness & ContractingFairness & ContractingFairness & ContractingFairness & ContractingFairness & Contracting

In order to comply with the Fairness In Contracting Legislation, and in an effort to inform our contracting providers,BCBSIL has designated a column in the Blue Review to notify you of any changes to the physician fee schedules. Be sureto review this new area each month.Reimbursement for codes 90714 and 90715 were updated effective August 1, 2005. The following code ranges, Q0166 -Q3025 and Q4080 - Q9956 will be updated effective September 1, 2005. Please note that not all codes in these ranges willbe updated.

Providers can request fees by downloading the Fee Schedule Request Form at www.bcbsil.com/provider/forms.htm.

What Members Will ExperienceWhat Members Will ExperienceWhat Members Will ExperienceWhat Members Will ExperienceWhat Members Will ExperienceWe will employ an “information only” approach to ad-

vise members about the Designated Centers for Bariatric Sur-gery. Non-HMO members who contact our customer servicedepartment with questions about obesity treatment will bedirected to a special BCBSIL Web site on bariatric surgery.Customer service representatives will also be prepared toprovide information by telephone for members without ac-cess to the Internet. HMO members will continue to havetheir care coordinated by their PCPs, who now have the ad-ditional option of recommending one of the centers.

Referrals to these centers is voluntary. The reimburse-ment amounts paid to hospitals and surgeons for bariatricsurgery will remain the same whether a member uses aDesignated Center for Bariatric Surgery or another con-tracting hospital. The standard financial risk applies forthe HMO program. When using a Designated Center for

Bariatric Surgery, membersshould confirm that the sur-geon is part of the contractingnetwork by calling customerservice. This network informa-tion will not be included indirectories, but the list will beavailable to physicians, members, employers and produc-ers online.

Supporting BCBSIL’s management of obesity issues isDr. Charles Baum, a nationally-recognized, board certifiedphysician specializing in clinical nutrition. BCBSIL in-tends to make a Web-based decision support tool availableto its members. This tool will show options that are avail-able to treat obesity, including the benefits and risks associ-ated with bariatric surgery. It is anticipated that this toolwill be available in 2006.

7


Third and Fourth Quarter Workshop ScheduleThird and Fourth Quarter Workshop ScheduleThird and Fourth Quarter Workshop ScheduleThird and Fourth Quarter Workshop ScheduleThird and Fourth Quarter Workshop ScheduleConfused by BCBSIL’s products and procedures? Baffled by reimbursement requirements, out-of-state claims processing

or electronic support mechanisms? Want to improve your claims filing to achieve faster payment turnaround?The Provider Affairs Education Team is dedicated to promoting your success in these and other critical areas by raising

your awareness of BCBSIL systems, operations and requirements. We provide learning that can help you streamline youradministrative processes, increase staff efficiency and stay in tune with evolving BCBSIL and industry trends that impactyour business. Through our informative workshops and specialized seminars, both new and experienced providers willgain the know-how to achieve administrative success as network participants.

Don’t delay! Sign-up now for one of our free workshops and begin to grow. You’ll be glad you did! Go towww.bcbsil.com/provider/training.htm for workshop times, agendas and to register online. A confirmation or “Request to Re-schedule” form will be e-mailed to you.

Billing Service WorkshopBilling Service WorkshopBilling Service WorkshopBilling Service WorkshopBilling Service WorkshopOff-site Workshop—Half DaySeptember 12, 2005St. John’s Hospital—Springfield

BlueCard WorkshopOff-site Workshop—Half DaySeptember 14, 2005Northern Indiana Education Foundation—Michigan City, IN

Hospital WorkshopOff-site—Half DaySeptember 21, 2005Memorial Medical Center—Springfield

Labor Union Group Focus WorkshopOff-site Workshop—Half DaySeptember 21, 2005FHN Memorial Hospital—Freeport

BlueChoice WorkshopIn-House—Half DaySeptember 28, 2005—CancelledNovember 16, 2005

Provider WorkshopsProvider Workshops

Managed Care Roundtable—October 26, 2005The next Managed Care Roundtable will be held on October 26, 2005, from 8:30 - 11:30 A.M. at BCBSIL. All HMO MG/

IPA Medical Directors are encouraged to attend. However, the meeting is open to all Network Physicians. Registrationis required and must be completed online at www.bcbsil.com/provider/training.htm. The October 26th agenda and regis-tration form will be posted as soon as it is available. You may call (312) 653-8668 with any questions.

Have you ever needed to order a duplicate ProviderClaim Summary (PCS) from our Provider Telecommu-

nications Center (PTC)? Would you like to improve theturnaround time receiving them? We now have the solu-tion. Our new Voucher mailing system has arrived.

Beginning September 1, 2005, BCBSIL will offer the Pro-vider Claim Summary (PCS) on a CD Rom. You will nowhave the option of receiving the information on a CD in-stead of a paper copy.

Provider Claim Summaries offered on CD RomBenefitsBenefitsBenefitsBenefitsBenefitsThe PCS on CD Rom is very user friendly and:

Offers a quicker turn around time.Gives you the option of searching by individual patients.Requires less storage space.Allows you to receive multiple vouchers on one disk

Please contact our PTC at (800) 972-8088 to request yourvouchers today.

Provider Claim SummaryProvider Claim Summary

Hospital WorkshopIn-House—Half DayOctober 5, 2005

New Contracting ProviderIn-House Workshop—Full DayOctober 19, 2005

Vendor WorkshopVendor WorkshopVendor WorkshopVendor WorkshopVendor WorkshopIn-House Workshop—Half DayOctober 20, 2005

Experienced Contracting ProviderIn-House Workshop—Half DayNovember 2, 2005

Experienced Contracting ProviderOff-site Workshop—Half DayNovember 9, 2005Mercy Hospital and Medical Center—Chicago

HMO Administrative ForumIn-House—Half DayNovember 30, 2005



A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association

PRSRT STDU.S. Postage

PAIDPermit No. 581CHICAGO, IL300 E. Randolph Street – 25th Floor, Chicago, Illinois 60601-5099

BlueCross BlueShieldof Illinois

For Contracting Institutional and Professional Providers

blueREVIEWREVIEWwww.bcbsil.com/provider

Sending YSending YSending YSending YSending Your Commercial Claimsour Commercial Claimsour Commercial Claimsour Commercial Claimsour Commercial ClaimsElectronically Has Never Been EasierElectronically Has Never Been EasierElectronically Has Never Been EasierElectronically Has Never Been EasierElectronically Has Never Been Easier

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THIN, Inc., a wholly - owned subsidiary of Health Care Service Corporation, aMutual Legal Reserve Company, is an all Payer electronic data clearinghouseconnected to over 1360 payers. Providers and vendors can submit all lines ofbusiness to a single source. This service provides “one-stop shopping” to helpour customers save time.

IS HERE FOR YOUIS HERE FOR YOUIS HERE FOR YOUIS HERE FOR YOUIS HERE FOR YOU

Just one solutionJust one solutionJust one solutionJust one solutionJust one solutionfor all your billing needsfor all your billing needsfor all your billing needsfor all your billing needsfor all your billing needs

If you already submit your Medicare, Blue Cross and Blue Shield and Illinois Department of Public Aid (IDPA) claims di-rectly to BCBSIL, why don’t you include your commercial claims as well?

In addition to saving time, THIN Commercial Services can also save you money. Once your commercial claims are re-ceived, they are forwarded to the payer free of charge!

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One-stop shopping—Claims filing through one clearinghouseEasy, fast and reliableNo more claim forms—reduces paperReduces administrative costs and timeIncreases the accuracy of claims throughoutImplement many Payer specific custom edits to insure cleaner claimsDedicated Payer Representative, Account Representative, and Technical analyst assigned to all Payers through out thelife of the accountEasy to develop THIN proprietary response reports and confirmation reports for reconciliation

Getting StartedGetting StartedGetting StartedGetting StartedGetting StartedTo sign up today, call our EDI Hotline at (312) 653-7954. You may also contact your assigned EDI Representative to learnmore.

InsideNew Specialties Added to PPONetwork: APN/DME/HIT.................1

BlueCard Satisfaction Increases..........2

HMO Member Satisfaction Survey....3RealMed.................................................4Medicare Crossover Update...............5New Account Groups.........................6Professional Reimbursement..............6Workshop Schedule............................7PCS Offered on CD Rom...................7Extra! Extra!BCBSIL’s New Designated Centers forBariatric Surgery..................................1

blueREVIEWREVIEW · back from our telephone and field rep-resentatives who interact closely with providers. We use this research to ... character alpha prefix If you have questions

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