Archive for the 'BCBSNC' Category

Member Health Partnerships has changed to better accommodate members with chronic conditions

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Jana
on July 27, 2010
in BCBSNC and Health and Wellness
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Since July 1, BCBSNC has made some changes so that it is easier for members to enroll and participate in the Member Health Partnerships (MHP) program. Earlier, sign up was done by completing a mail-in survey only. Now, there are new options such as enrolling by phone and beginning in September, members will have the ease of being able to join online. They are no longer using the paper surveys. Members can easily join by calling 1-800-218-5295 and press 1.

Also the educational materials have been updated. Numerous books are no longer accessible, but have been replaced with exceptional substitutes. Members can sign up using email or phone to get great tips concerning weight management or smoking cessation. The pregnancy program even has an optional text-messaging feature. All members signed up for the program will acquire a Chronic Care Guide.

The outreach efforts are now concentrated on members at the highest risk level. Members who are considered “most impacted” will be called by specially trained nurses who will invite them to engage in health coaching and to join the MHP program. The hope is to reach more of the members who will benefit the most from the program.

The Pregnancy program has been changed to self-refer only, because it is sometimes very hard to identify members early in their pregnancy. Claims will be monitored for high-risk pregnancies and these members will be referred to a case manager.

All members’ claims will be constantly monitored for status changes, and the outreach will be adjusted accordingly. The “most impacted” members will receive a phone call from  a health coach, who will work with them whether or not they choose to enroll in the MHP program.

The members who are identified for the program but not considered “most impacted” will get a mailed invitation. The members who do enroll in the Member Health Partnerships program will receive  an annual mailing.

Some things will remain the same. Members who join our programs will still continue to receive targeted information and services, which will help them take care of their particular health care needs. Customized benefits, like nutritional counseling and discounts are also available to members. Members currently in the MHP program will not have to do anything to remain in the updated program; they will automatically be enrolled.

BCBSNC CEO is now in favor of health reform bill

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Jana
on April 6, 2010
in BCBSNC and Health Insurance
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The CEO of Blue Cross and Blue Shield of North Carolina, Brad Wilson, has recently revealed that he stands behind the health-care reform bill that passed in the evening of March 21. He says “It’s a step in the right direction, however, there is still a lot of work to do to give Americans a health-care system that they can both depend on and afford.”

He also appealed to Congress for them to try and tackle the rising health-care costs that have caused major surges in the cost of insurance in the past few years.

This surprising show of support from the CEO of BCBSNC is in sharp contrast for the insurance company that was formerly opposed to the bill and even organized a campaign that debated against health-care reform legislation passed by the House of Representatives.

Wilson announced that his company, the state’s largest health insurer, is getting ready for the changes that the new law will bring. Just days before taking over from Greczyn on February 1 from COO to CEO, Wilson announced to TBJ that his reservation over the health-care reform was his utmost concern about BCBSNC. The company controls almost 97 percent of individual of the health insurance market in North Carolina.

BCBSNC says stick it to the flu

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Jana
on October 10, 2009
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Want to knock out your chances of getting the flu? Well, Blue Cross and Blue Shield of North Carolina (BCBSNC) wants you to stick it to the flu by getting your flu shot. It is presenting this message through its Stick it to the Flu Campaign which will run through March.

As part of the campaign, BCBSNC will cover the cost of the seasonal flu vaccine for customers with preventive health benefits. A co-payment, deductible or coinsurance may be charged to some customers, depending on their specific benefits. BCBSNC is also suggesting that customers get the separate H1N1so vaccine, and the out-of-pocket costs will be waived for eligible customers.

Dr. Don Bradley, senior vice president and chief medical officer for BCBSNC, says that the flu shot is the best way to keep from getting the seasonal flu and transferring it to others. He says “We are making it easy for our customers to get their seasonal and H1N1 flu shots by simply visiting their primary care doctor, worksite clinic or participating pharmacist in the BCBSNC network.”

As with insured customers, BCBSNC issues health plans for companies and organizations that are self-insured (The employer pays BCBSNC to administer the plan). Employees of such self-insured companies can check with their supervisors or HR Department to determine how the seasonal and H1N1 vaccine will be paid.

BCBSNC, using guidance from the Centers for Disease Control (CDC) and the Prevention’s Advisory  Committee on Immunization Practices, has decided to cover the H1N1 vaccine. The Prevention’s Advisory Committee on Immunization Practices has predicted extensive outbreaks this fall and winter.

When the H1N1 vaccine is available, BCBSNC customers have the option to go to their physician, in-network pharmacist or CVS Minute Clinic to get a H1N1 vaccine that will be covered. They advise customers to contact their provider to make sure that the vaccine is available.

It is strongly recommended that people get both vaccines to be completely protected against the seasonal and swine flu. These can be administered on the same day.  The 2009 H1N1 vaccine does not replace the seasonal flu vaccine. You must get each vaccine for the best protection.

The CDC says that those who are the first to get the H1N1 vaccine are pregnant women, people who live with or provide care for infants less than 6 months of age, heath care and emergency medical services workers, children and young adults ages 6 months to 24 years and adults ages 25 to 65 years with medical conditions that have put them at a higher risk for flu-related complications.

More than 100 million doses of the seasonal flu vaccine will be available this flu season, according to the CDC estimations. The U.S. government plans to have 6 to 7 million doses of the H1N1 vaccine in October and 250 million doses by the end of the year. The North Carolina Department of Health and Human Services reports that between 1000 to 2000 people die of seasonal influenza and pneumonia in North Carolina each year. The CDC estimates that more than 200,000 people are hospitalized with the seasonal flu every year and that there are 36,000 deaths from it yearly.

Blue Cross and Blue Shield of North Carolina is a leader in advanced health care products, services and information to more than 3.7 million customers, which includes 900,000 served on behalf of other Blue Plans. The company has served its customers for 76 years by offering health insurance at a reasonable and competitive price and has served the people of North Carolina through support of community organizations, programs and events that support good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. You can access BCBSNC online at www.bcbsnc.com.

BCBSNC changes for Blue Medicare Supplement makes Explanation of Benefits less confusing for members

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Jana
on April 23, 2009
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Since January 1, 2009, Blue Cross and Blue Shield (BCBSNC) has altered the arrangement of its Explanation of Benefits (EOB) for Blue Medicare Supplement products, to reveal what the provider charged and what Medicare allows. This information is found in the column, “Amount Provider May Bill You”.  In the past, even though this amount was a precise statement of the difference between the two charges, many beneficiaries were perplexed about the correct amount that they were responsible for. Because of this confusion, BCBSNC has redesigned the EOB presentation for Blue Medicare Supplement Products in order to make it easier for members to understand what they actually owe.

Last year, there was perhaps too much detail about the amount that was not owed by the members on the EOB in the section of the EOB titled “Paid by Medicare or applied to deductible.

The contractual difference between what the provider charged and what Medicare allows is shown this year in the ‘Explanation of Amount Provider May Bill You’ section. Any amount that the member is responsible for under their current plan is also shown. Now, to make things clearer for the member, the ‘Explanation of Amount May Bill You’ section now states, “This amount represents remaining expenses after Medicare and BCBSNC Plan determination.”

So what do members need to do? Well, the member should compare their EOB with our EOB to see how much they are financially liable for. They can do this by looking at their EOB that is sent to them once every quarter from Medicare.

The advantages in paying BCBSNC with automatic bank draft transactions

Published
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Jana
on April 15, 2009
in BCBSNC
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When you are going through the procedures for purchasing health insurance, and you have finished the quoting part with Blue Cross and Blue Shield of North Carolina, they will help you make the best selection for you and your family. After this, you will need to supply BCBSNC with the initial premium payment. If a credit card is used, it will be charged at the time that coverage is accepted. Even though your insurance policy’s effective date is thirty days from your acceptance, your credit card will be charged instantly.

Your credit card will be used for the first payment only. All succeeding payments will be billed to you monthly. Actually, BCBSNC will let you pay with the credit card monthly, but the credit card portion of the premium statement must be filled out each month. With monthly billing, most members will pay with a check because it tends to be easier.

Arranging to have your account automatically debited, is most likely the easiest method to ensure that your health insurance payment is taken care of every month. All you have to do is to give them your name as it is printed on your check and the routing and account numbers. It really is better for everyone involved, mainly because you don’t have to remember to write a check each month. It would be terrible to have your insurance lapse, simply because you were too busy or on vacation. It is less costly and more green for the environment for BCBSNC to debit your account than to deal with a paper check and send you a paper bill.

If you have to cancel your insurance, you don’t need to worry about BCBSNC forgetting to stop your automatic debit. Unlike some businesses that carelessly forget to stop automatic debit once a customer ceases business, BCBSNC is extremely conscientious when it comes to stopping automatic debits on time. The North Carolina Department of Insurance regulates all North Carolina insurance companies, so as long as you follow the right steps to end an automatic debit, there shouldn’t be any problems. All you have to do is to give BCBSNC a letter asking for cancellation of your policy on a certain date, the policy number, the names of persons covered on the policy and your signature.

Blue Advantage BCBSNC bank draft transactions are processed on the 5th of the month in which a policy is effective. On-going drafts take place on the 5th for bills at the first of the month and 12th and 15th of the month for mid month bills.

The Blue Options HSA(SM) product will always be processed at the 1st of the month bill cycle, no matter when an individual chooses their effective date. With this product, the usual rule for drafts is that they happen on the 2nd day of the month that a policy is effective. The draft will occur right away if it is effective after the second of the month.

For those with the Blue Options HSA(SM) plan with an effective date on the 15th, they could draft right away for only 15 days of the premium, then succeed with an additional full month draft on the next 5th of the month. Here is an example: Effective date is 3/15, enrollment is 3/23 and an immediate draft takes place for 15 days. On 4/5, there is a draft for the full month. Also, a 45 – day draft will happen in this example if enrollment doesn’t occur until 4/1 of after.

To sum up everything mentioned, it is easiest and safest to have BCBSNC automatically debit your checking account each month. But if you still prefer to be billed monthly, use your credit card for the first payment.

BCBSNC increases the use of electronic prescribing by more than 50 percent

Published
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Jana
on March 26, 2009
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The use of ePrescribe, a Blue Cross and Blue Shield of North Carolina statewide electronic prescribing strategy, is becoming more prevalent with physicians and pharmacies. So what does this mean for more North Carolinians? They will have the advantage of heightened prescription precision and safety.

The number of doctors that used electronic prescriptions in the last quarter has doubled to more than 2000, according to the most recent ePrescribe findings. Also, more than 87 percent of N.C. pharmacies have adopted the electronic prescribing in order to better suit their customer’s prescription needs.

Dr. Ron Smith, BCBSNC vice president of Employer Health and Corporate Pharmacy, says that there is an expanding use of electronic prescribing for both N.C. physicians and pharmacies. This allows physicians instant access to a patient’s medical and drug history so they can avoid any possible drug interactions. They can also view the patient’s health plan with the ePrescribe system so they can discuss the different costs of drug choices, as well as the consideration of generic drugs before a prescription is written, which can save the patient $30 or more per prescription.

BCBSNC was the earliest insurer in North Carolina to diligently endorse the use of electronic prescribing. There have been more than 7.8 million electronic prescriptions issued, since BCBSNC began the ePrescribe program in 2006.

The ePrescribe program was started by BCBSNC with a partnership with Community Care of North Carolina (CCNC) and North Carolina Medicaid to boost prescription accuracy and increase patient safety. BCBSNC continues to encourage electronic prescribing for all N.C. providers and to work with CCNC to help support the program.

An electronic prescribing solution is being made available by BCBSNC on their web site to assist every licensed provider in its network to begin electronic prescribing. There is no downloading and new hardware requirement on the web site. The BCBSNC web portal is safe and can be accessed easily by most computers, handheld devices or cell phones.

BCBSNC will offer free generic medicines with new Generic Waiver Program

Published
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Jana
on December 1, 2008
in BCBSNC
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Blue Cross and Blue Shield of North Carolina is once again helping members out with their prescription drug costs with a new generic copayment waiver program. This new version is a more revised and condensed edition of the generic copayment waiver programs that they have used in previous years. The new program’s purpose is to motivate some members to shift to less expensive medicines. It is also a way to raise medication use during a troubled economy, for patients taking drugs for chronic conditions. They want to reduce surging drug costs.

The company is concerned about the fall of prescription use during the last few months. This reveals that many people are not getting the prescriptions that they need to maintain their health.

Blue Cross will pay, but the costs are counteracted because the amount that it pays in all for drugs decreases. The cost for an average brand-name drug currently cost $130 for a month’s supply. The average generic medicine is only around $19.

Once brand-name drugs lose patent protection, federal regulations permit generic versions of medicines. This causes pharmaceutical companies behind the original drugs to suffer, while offering cheaper substitutes for consumers.

Blue Cross fosters generics to prescribing physicians. Drugstore chains such as Walmart, Target are now offering inexpensive generic co-pays. Increasing the amount of generics that are available is a huge priority according to regulators.

The most current data from the N.C. Institute of Medicine shows that the amount of money spent of prescription drugs in N.C. has almost increased 50 percent faster than combined health costs from 1991 to 2004. Mark Holmes, vice president of the institute, says that programs like Blue Cross are effective at getting people to buy the generic version of the drug, which saves the consumer and the insurer money for a treatment that is just as effective.

There are a few restrictions to the Blue Cross program. It is not accessible to groups in which the insurer only provides the coverage. This includes state and federal workers. Also members with drug deductibles must satisfy that stipulation first. Blue Cross currently has about 3.7 million members.

Under this new Generic Waiver Program, copayments and coinsurance for all generic prescriptions filled or refilled between January 1, 2009 and June 30, 2009 will be waived by BCBS of NC. Underwritten (fully insured) groups and individual members will be eligible for this program. Also, self funded or ASO groups may partake in the program. The ASO clients will be furnished with more detail as needed.

Hospital quality program successful for Blue Cross and Blue Shield

Published
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Jana
on November 24, 2008
in BCBSNC
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The Blue Cross and Blue Shield Association has been victorious with their hospital quality program. The association revealed at a news conference recently that patient outcomes have significantly improved, and costs have been diminished.

The program has been implemented in 45 states with certified centers containing four categories: cardiac care, bariatric surgery, transplants and complicated and rare cancers. There are 800 programs at 650 hospitals within 45 states.

Establishments using the program have shown a 26 percent lower rate for bypass surgery readmission and a 37 percent lower rated for outpatient angioplasty readmission. All this has occurred within an astonishing 30 days. This was revealed in a study by WellPoint on 41,000 patients. Also, bypass procedure costs at these hospitals came to be five percent less than facilities that did not take part in the study, and outpatient angioplasty costs were an amazing 12 percent lower.

To improve health status, employees need employer’s help

Published
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Jana
on October 27, 2008
in BCBSNC and Health and Wellness
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A survey by the Washington-based National Business Group on Health found that employees want to improve their health, but they need help from their employers in order to do it. They also said that the demands of personal life, work and stress levels are preventing them from achieving their health improvement goals. The survey showed that 47 percent of employees are not able to lead a healthier life because of work demands. Also, the survey discovered that employees want health care that takes care of their specific needs and interests. They want to get more value from their health plans and learn how to save money.

The good news is that more employees are becoming more active in their health-care choices during yearly enrollments. It was found that 73 percent reviewed their health plan options for their 2008 enrollment.

Blue Cross and Blue Shield of North Carolina (BSBSNC) is ahead of the game when it comes to employees becoming more active in their health. They have created a program called Workplace Wellness. Employers can go to their website, workplacewellness.com, to get ideas so they can begin their own wellness program that will help get their employees healthier. Using this program has proven to not only help get employees healthier, but to help employers and employees save money.

Blue Cross and Blue Shield of North Carolina has innovative and helpful website

Published
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Jana
on October 22, 2008
in BCBSNC and Health Insurance
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Blue Cross and Blue Shield is an efficient, responsive and technologically innovative and advanced health insurance company. Their website, bcbsnc.com, reveals this as you will be able to access anything you need that relates to health care. Some of the things you can find on this website include coverage plan information for individuals and groups, a provider directory, hospitals, doctors, research centers, rates, legislative news and links to more health related sites.

This Blue Cross and Blue Shield website, bsbcnc.com, also helps people find information on their full range of managed care programs for individuals, families, employer groups and seniors.

Also, by logging in, members can manage their accounts, make payments, request a visit with a doctor, fill or print forms, or even take a look at their bills or get a copy of previous bills.

Because this site offers such varied and educational links, it is not only useful for Blue Cross and Blue Shield members, but for anyone who is interested in health related issues.

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