Tag Archive for 'BCBSNC'

BCBSNC and Maria Parham Sign Medicare Advantage Contract

Published on April 30, 2013 in Uncategorized. 0 Comments Tags: , , , , .

Blue Cross and Blue Shield of North Carolina is pleased to announce that Maria Parham hospital, in Vance County, is now participating in their Blue Medicare Advantage network.  Blue Medicare HMO and PPO members can now use Maria Parham Hospital as an in-network provider.  This relatively new negotiation incorporates the hospital and all related providers of Maria Parham Medical Center.  BCBSNC is currently in the process of adding Maria Parham to all our online directories and systems, and they expect that this will be completed soon.  In the meantime, Maria Parham began allowing members to utilize their facilities as in-network on February 15, 2013, and will begin submitting claims once they are set up in their systems.

 

BCBSNC and the North Carolina Museum of Art Launch Triangle’s Newest Greenway Trail

Published on April 17, 2013 in Uncategorized. 0 Comments Tags: , , , .

Blue Cross and Blue Shield of North Carolina (BCBSNC) and the North Carolina Museum of Art (NCMA) presented a new greenway trail called the Blue Loop on April 13. This mile-long loop, which is conveniently located on the museum’s 164-acre Raleigh campus, is an important component of BCBSNC’s Get Outside North Carolina! initiative (GO NC!).

The Blue Loop contains a system of recreational trails on NCMA’s campus and links the Museum Park to the Capital Area Greenway System. The new trail provides NCMA visitors with physical activity and art. There is no charge for North Carolinians and visitors to use the trail for walking, cycling and running.

Brad Wilson, BCBSNC president and CEO said, “Studies show that physically active people can save $500 per year on their health care costs, which is something that should get everyone’s attention,”. “By collaborating with organizations such as the North Carolina Museum of Art to support new opportunities for exercise, we’re giving North Carolinians opportunities to be active and stay healthy, which can make a real difference in their health care spending.”

BCBSNC is offering new opportunities to help North Carolinians get active, reduce obesity rates and control their medical costs with the four-year GO NC! initiative.

The City of Raleigh first founded the Capital Area Greenway System in 1974 to provide citizens with a place for outdoor recreation when the city began to grow rapidly. Today, the system has grown to an 88-mile, 3,700-acre system.

Lawrence J. Wheeler, director of the NCMA said “As America’s largest museum art park, we have the opportunity to offer North Carolinians and visitors with a unique recreational destination that promotes healthy living and provides public access to art,”. “The Blue Loop allows us to offer a new experience to our members and area visitors.”

 in July 2012 BCBSNC’s GO NC! began with the launch of Charlotte B-cycle, the first bike-share program in North Carolina and the largest urban system in the Southeast.  Charlotte citizens and visitors have checked out the bikes almost 22,000 times and burned more than 3.5 million calories as of April 2013.

This past July, BCBSNC also announced its effort to help complete the Gary Shell Cross-City Trail, a 15-mile trail that runs from downtown Wilmington to the drawbridge at Wrightsville Beach. Construction is now in the works and will be complete in the fall of 2013.

For more information, visit www.bcbsnc.com/gonc. Or follow BCBSNC and NCMA on Facebook and Twitter. You can join the conversation online with the #GONC or #BlueLoopNC hashtags.

For more information about the Museum Park, visit www.ncartmuseum.org/park.

Prescription Drug Prior Review and Limitations Information Is Now Easier to Find due to redesigned website

Published on April 17, 2013 in Uncategorized. 0 Comments Tags: , , .

The Prior Approval/Review and Limitations section of bcbsnc.com is now easier for agents, providers and customers to find detailed information about prescription drugs.

One can now easily search for each drug by name from the alphabetical glossary, and find the information listed below:

  • The type of review required (prior review, quantity limitation, or restricted access / step therapy)
  • The criteria required to meet approval
  • If the drug is automatically covered under all BCBSNC formularies (Basic and Enhanced)

The new web link is www.bcbsnc.com/umdrug.  Feel free to bookmark this page for future reference.

Please note that this new site does not apply to the State Health Plan, Federal Employee Program, or Blue MedicareSM.

BCBSNC Initiates Let’s Talk Cost Comprehensive Communication Plan

Published on March 4, 2013 in BCBSNC and Health Insurance. 0 Comments Tags: , , .

 

BCBSNC has jumped to the next level in educating consumers about the many factors driving rising health care costs with a comprehensive communication campaign that commenced on Monday, February 25.  The campaign includes TV commercials, various types of advertising, and a newly formulated website, www.LetsTalkCost.com.

BCBSNC began the Let’s Talk Cost campaign in 2011 to begin a beneficial statewide conversation about soaring medical costs and to provide solutions for this perplexing problem. Even though most residents of North Carolinia are aware that their medical expenses and insurance premiums increase each year, many still don’t understand the reasons for the their incurred costs.

Most people agree that there are many reasons why costs continue to climb, but this dilemma cannot be solved without understanding the sources of the problem. Let’s Talk Cost helps uncover the elements that trigger these rising medical costs, which help us all collaborate together so that costs can be controlled and reduced.

To check out the new site and view the TV commercials, click below.

http://connect.bcbsnc.com/lets-talk-cost-2013/the-cost-problem/posts/cause-overview/

http://connect.bcbsnc.com/lets-talk-cost-2013/the-cost-problem/waste/posts/cause-waste/

With BCBSNC and Rival Fusion, NC businesses will get fit in 2013

Published on February 20, 2013 in BCBSNC and Health and Wellness. 0 Comments Tags: , , .

Blue Cross and Blue Shield of North Carolina (BCBSNC) has accepted the Get Fit Challenge to begin 2013 with a healthy boost. This 60-day program, sponsored by Rival Fusion External link, will direct 85 North Carolina businesses to better health in the coming year. Fitness plans that are customized, will be administered by The Challenge to participating employees to help employees get in shape, lose weight, create healthy habits and operate together to lower company health care costs.

“BCBSNC is committed to finding new ways to rein in medical costs and make health care more affordable,” said Sean Kerns, vice president of Specialty Markets. “Businesses face the challenge of rising health care costs on a daily basis. Our Get Fit Challenge is a way to spark a little healthy competition within the business community and help companies introduce a new wellness option that can help reduce medical spending.”
Rival Health’s Rival Fusion External link software will provide a 60-day customized health and fitness program for participating employees. The program will help employees work toward their fitness goals and New Year’s resolutions with nutritious recipes, motivational tips and easy-to-use tools for monitoring progress. Employees will also receive a collection of Rival Fusion External link DVDs that will provide personalized exercise routines based on their specific profile and goals.
North Carolina businesses that are current BCBSNC customers comprising more than 50 employees qualified to participate in the Get Fit Challenge and compete against companies of comparable sizes. BCBSNC is investing in North Carolina businesses by covering the cost of the fitness program for up to 100 employees at each participating company. For every $1 invested in wellness programs, businesses can save more than $3 in medical costs[i].
The winners will be announced in March. The three companies that advance their fitness levels the most will be awarded up to $5,000 to help encourage healthy workplace habits once the challenge is over.

BCBSNC and Duke University Health System team up to improve the quality and efficiencies of knee replacement surgery

Published on February 4, 2013 in BCBSNC and Health and Wellness. 0 Comments Tags: , , , .

Durham, N.C. — Duke University Health System and Blue Cross and Blue Shield of North Carolina (BCBSNC) are teaming up in an effort to save money and enhance the standard of excellence in knee replacement surgeries under Duke’s nationally ranked orthopedic service. By seeking technological advances  in care coordination and delivery, Duke’s care teams will perfect joint replacement services while working toward decreasing the cost of care.
The intention of this project is to replace the individual costs of each of the many services provided for a successful knee replacement with a single flat-fee proposed to cover everything affiliated with this event of care. Duke and its care teams will continue to attain the high quality efforts that have made them an enduring top 10 orthopedic service by U.S. News & World Report, while also administering the entire knee replacement surgery care within the flat-fee reimbursement.
“These kinds of efforts in new care models that help drive greater efficiencies while increasing quality will become more and more prevalent and clearly represent the future of health care delivery,” said Victor J. Dzau, M.D., Chancellor for Health Affairs at Duke University and CEO of Duke University Health System. “Duke is committed to being a leader in exploring new treatment models that achieve the triple aim of better access, higher quality and lower costs.”
This “bundled payment” project will encompass the entire knee replacement care range, including the pre-surgical period of 30 days before hospitalization, the surgery itself, and most follow-up care within 90 days after discharge from the hospital. This program became effective on Jan. 1, 2013, and will be available to BCBSNC members when knee replacement procedures are performed by Duke University physicians at Duke University Hospital or Durham Regional Hospital.
“Partnerships like this one are possible when hospitals, physicians and insurers commit to new ways of putting patients first by collaborating to improve quality and reduce costs,” said Lisa Cade, BCBSNC Vice President of Network Management.
David Attarian, M.D., medical director of musculoskeletal services and vice chair for orthopedic clinical operations at Duke said “This project is a great example of collaboration between providers and a payer to advance care, but it also provides more tangible ways to engage patients directly in optimally contributing to their successful outcomes.”

BCBSNC Cardiac Disease Risk Tests Medical Policy Changes

Published on December 17, 2012 in BCBSNC and Health and Wellness. 0 Comments Tags: , , , , , , , , , , .

Effective January 1, 2013, tests listed in the policy “Cardiovascular Disease Risk Tests” will be considered investigational and non-covered services under BCBSNC.

BCBSNC will not be implementing the previously proposed changes to the Urinary Tumor Markers for Bladder Cancer medical policy on January 1, 2013, as previously advised on November 28, 2012. If this changes, members will be notified.

Nontraditional cardiovascular disease risk tests are laboratory tests ordered by physicians to assess a patient’s likelihood of developing cardiovascular disease. Traditionally, physicians use standard cholesterol and triglyceride measurements, as well as an assessment of smoking, weight and family history to determine a patient’s risk. Nontraditional cardiovascular disease risk tests include;

  1. Apolipoprotein
  2. Lipoprotein, blood; electrophoretic separation and quantitation
  3. Lipoprotein (a)
  4. Fibrinogen; activity
  5. Electrophoretic technique, not elsewhere specified
  6. Cystatin C
  7. Very long chain fatty acids

BCBSNC is changing its coverage for these cardiovascular disease risk tests because it has been receiving a higher volume of cardiovascular disease risk tests that lack clinical utility and have not been proven to improve patient management or health outcomes. BCBSNC’s decision to deny these tests as investigational is founded on evidence based research produced at a national level.

The evidence- based guideline titled “Novel Lipid Risk Factors in Risk Assessment of Cardiovascular Disease” will remain effective until December 31, 2012.The new corporate medical policy titled, “Cardiovascular Disease Risk Tests,” which lists the nontraditional tests will be effective January 1, 2013.There will still be some treatments that can be used in place of these nontraditional cardiovascular disease risk tests such as standard cholesterol measurements for LDL, HDL and triglyceride levels.

 

2013 Renewal Information for Individual Under 65 Plans

Published on December 12, 2012 in BCBSNC and Health Insurance. 0 Comments Tags: , , , .

 

On November 18, BCBSNC added the following functionalities to Member Services for a 1/1/13 effective date for Blue Advantage, Blue Options HSA and Blue Advantage Saver plans:

Changes to Existing Members’ Policies:
  • adding newborn outside of 30 days from the date of birth/adoption/foster placement
  • adding a spouse
  • adding maternity
  • benefit changes

On November 10, BCBSNC also opened Buy Online for new enrollments. This becomes effective 1/1/13 for Blue Advantage, Blue Options HSA and Blue Advantage Saver plans.

On November 16, BCBSNC began mailing details about individual customers’ 2013 open enrollment on. Once they receive this information, members can log into Member Services to make their 2013 renewal changes. The open enrollment period for individual under-65 plans is November 18 through December 20.

 

BCBSNC now offering Dental Blue for Seniors

Published on November 23, 2012 in BCBSNC. 0 Comments Tags: , .

BCBSNC is now providing Dental Blue for Seniors. It gives you and your spouse a reliable choice when it comes to dental health. These benefits are available with this plan:

Take Care of Your Dental Health

Medical research shows a connection between dental health and many serious health conditions, such as diabetes and coronary heart disease.

Dental Blue for Seniors can help you take care of your dental health.

Choose Your Dentist

Dental Blue for Seniors makes dental insurance quick and easy:

  1. Schedule your appointments with any licensed dentist.
  2. Show your BCBSNC member ID card at the dentist’s office when you arrive.
  3. File your claim (although many dentist offices will file for you).

Reliable and Convenient Dental Coverage

With Dental Blue for Seniors, you get:

  • A convenient monthly premium
  • The freedom to see any licensed dentist in NC or choose one from BCBSNC’s expansive network
  • No waiting period for preventive services
  • Coverage for basic services (routine fillings or extractions) and major services (crowns, dentures
    and bridges)*

* Dental Blue for Seniors is not part of the covered health insurance benefits of any BCBSNC plans. Dental Blue for Seniors must be purchased separately.

  1. “The Health Perils of Gum Disease.” http://www.webmd.com/heart-disease/features/health-perils-of-gum-disease (Accessed October 2012).

Diabetes Progress Report Letter sent out in November

Published on November 23, 2012 in BCBSNC and Health and Wellness. 0 Comments Tags: , , , .

During the first week of November, BCBSNC sent letters to members 18 years and older who have been diagnosed with diabetes and have one or more gaps in their care, based on available Blue Cross and Blue Shield of North Carolina (BCBSNC) claims data. A progress report in the letter outlined the most recent screening information.

The letter included the following key messages:

  • Importance of regular screening tests to control diabetes
  • A list of the most recent diabetes screening information (if available)
  • A description of the diabetes screenings and their recommended frequency
  • Instructions to complete an enclosed form, if the screening information on the letter is incorrect
  • An incentive offer to complete the screenings prior to 12/31/12: Please note that BCBSNC will not send the notifications for claiming the gift cards until April 2013, to allow time for BCBSNC to capture all of the claims for screenings completed in 2012
  • Members are encouraged to call their provider to schedule an appointment

Why is BCBSNC sending this reminder to its members?
Preventive care is one of the most important steps in controlling diabetes. Scheduling regular diabetes screening tests can help reduce the risk of future diabetes-related complications.

Members can choose whether or not to complete the screenings; this letter mainly serves as a reminder.