FOR HEALTHCARE PROFESSIONALS

oneone TO

SPRING 2015

Blue Cross of Idaho is launching a new and improved provider portal, tentatively set to launch in June. You will still have the same tools, but a clean, new look and feel will make using the website even easier.

The new top navigation feature allows you to see the tools you are already familiar with, while an additional My Favorites feature in the navigation bar on the right of the page allows you to bookmark pages. Each time you log in, the system recognizes you and remembers your personalized favorites list.

As the new provider portal launch gets closer, we’ll send more information and details. If you need any help with the existing portal, please contact your website trainers in our Provider Relations Department.

New Website Look and Feel

New Communications Plan Cuts Down on ClutterConsidering that most of us are inundated by information on a daily basis, Blue Cross of Idaho is changing our provider communication plan to streamline our efforts while still giving you all the information you need.

Beginning June 1, all communications regarding contractual issues, or that require a 30–60-day notification window, will continue to be

sent via provider alerts. But communications designed to be informational only will be posted to the provider portal of our website every Monday in the new Weekly News section.

Each Monday, the previous week’s notifications will be available in the Forms & Resources/Provider Notifications section of the provider portal, or by selecting the View All link below current notifications.

Please log onto our website, bcidaho.com/provider to view any updated news and announcements from Blue Cross of Idaho.

If you have further questions or need additional training on our website, contact the provider relations representative in your area (PAP100).

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New FacesJohn Welsh recently joined Blue Cross of Idaho as a provider information management specialist. He became a certified professional coder in 2010 and most recently worked for Elks Rehab System doing billing, payment posting, provider enrollment and serving as

charge master. He also previously worked at St. Luke’s Regional Medical Center as a systems analyst.

John enjoys staying active and spend as much time as possible outdoors with his wife and four children. The whole family loves to go hiking, skiing, paddle boarding, white water rafting and fishing. When they are home, they enjoy gardening. John is a big Boise State University sports fan who has been at every home football game tailgating with friends and cheering on the Broncos for many years.

Mandy Chung joined Blue Cross of Idaho as a provider information management specialist. In the past, Mandy has spent time doing administrative work and extensive customer service.

She enjoys spending time reading and going on nature walks.

Noelle Bruce returned Blue Cross of Idaho in March as a provider network management specialist. Noelle has worked with Blue Cross of Idaho as well

as Regence Blue Cross Blue Shield of Oregon in the past. She has extensive customer service, front-end hospital and clinic management experience, and brings extensive knowledge of operation of healthcare provider practices.

Noelle is looking forward to furthering the relationships between Blue Cross of Idaho and the various healthcare provider communities she has already established. She is also excited to focus her efforts on helping facilitate, streamline and optimize the transformation of the market place to help reduce the rising costs of healthcare.

Outside of work, she loves the outdoors and everything Idaho has to offer from camping, water and snow skiing, fishing, golfing and mountain biking.

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Individual Email Addresses Now RequiredIn order to comply with HIPAA requirements, offices using a shared email address to access the Blue Cross of Idaho provider portal will have to update their accounts so each registered user has a unique email address.

Individual email addresses not only provide better safeguards for personal health information and bank account data, but they help streamline our provider portal while allowing users to reset their account passwords more securely.

Registered users must have individual email addresses associated with their accounts no later than Friday, May 1. After that date, any accounts with shared addresses will be deactivated and deleted.

Please remember that anyone who is also a Blue Cross of Idaho member cannot use the same email address associated with his or her online member account. The email address linked to a provider portal account cannot be associated with any other Blue Cross of Idaho account.

To update email addresses, go to bcidaho.com and follow the instructions below:

n Log in to the provider portal

n Select Account Maintenance in the left navigation

n Select Edit next to each users name to update the email address

If you have any questions, please contact your external provider relations representative for assistance. (PAP100)

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Blue Cross of Idaho Mobile App

We are pleased to announce that the new Blue Cross of Idaho mobile app for smartphones was released on Monday, March 23.

The mobile app allows members to take charge of their healthcare insurance information while on the go. Users can access their key health insurance information whenever and wherever they need it, giving them the freedom of always having their most vital insurance information at the tips of their fingers.

The new app allows users to:

n Search for doctors, clinics or hospitals by name, location or specialty.

n Search for urgent care closest to where they are.

n Sign in to view details about specific benefits.

n See progress toward their yearly deductible.

n View member ID cards for the member and any dependents.

n Email or fax member ID cards directly to doctors or care providers.

n Get contact information and driving directions for doctors, care providers or urgent care.

The app is designed for Blue Cross of Idaho members, and requires users be registered members at members.bcidaho.com to use all the features available on this app. Members can use their login information (username and password) to access the full features of the app. But even without signing in, app users will still be able to search for doctors and urgent care. The mobile app is free to download and is available at both the Apple App Store and Google Play. Learn more about the app at bcidaho.com/mobileapp.

Survey Results Show Opportunities for Improvement

IN THE FALL OF 2014, Blue Cross of Idaho conducted an online survey of practitioners to collect information for clinical quality and member safety improvement efforts. The survey was designed to help with continuity and coordination of medical care across the network. The goal was to collect information from primary care practitioners (PCPs) and specialists about the timeliness, accuracy and completeness of information they receive about their patients in different settings, inpatient and ambulatory.

Through the survey, PCPs reported that they seldom or never receive information from specialists or hospitals approximately 46 percent to 64 percent of the time.

But the PCPs had a very different opinion about the usefulness of the information they send to specialists, hospital staff or ER staff. More than 80 percent felt that they always or almost always send useful information to specialists, and 36-46 percent felt they always or almost always send useful information to the hospital or ER.

Conversely, specialists reported that they sometimes receive useful information approximately 43 percent of the time, and almost always do so 35 percent of the time. Specialist reported that they always receive useful information only 7 percent of the time.

PCPs reported overall satisfaction with the accuracy and completeness of information from hospitals, specialists and ancillary providers when they receive it, however,

the timeliness of information was an area that showed potential need for improvement. PCPs stated that the information received met or exceeded their expectations only 70-92 percent of the time. The survey did not define timely, or accuracy or completeness.

Finally, specialists reported that they sometimes receive useful information from PCPs 43 percent of the time,

seldom 12 percent of the time, and never just 3 percent of the time. Timeliness, completeness and accuracy of information met or exceeded expectations for timeliness 96 percent of the time, were accurate 96 percent of the time and were complete 89 percent of the time.

The responses from PCPs and specialists provided sufficient information to identify several areas for improvement.

PCPs reported that they needed more information from hospitals for patient admissions and ER visits, and they, too, felt timeliness could be better.

Additionally, while PCPs felt the information they send is useful, specialists did not share that view. Often, the reason for a specialist consultation is not evident in the information received from PCPs. Overall, specialists need more details on why the member was referred, while PCPs need more follow-up information after the patient visited the specialist.

Blue Cross of Idaho would like to improve the continuity and coordination of care. We hope this serves as the beginning of an ongoing dialogue for everyone to share best practices and improve the timeliness and content of shared information.

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More than

80%

of PCPSfelt they

ALWAYS send useful information

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Survey Results Show Opportunities for Improvement continued

Primary Care Physician felt it was successful always or almost always

From Hospital/Specialist to Primary Care Physician

Specialist felt info was useful

From Primary Care Physician to Specialist/Hospital

75

100

50

25

0

75

100

50

25

0

75

75

100

100

50

50

25

25

0

0

TO SPECIALISTS

TIMELINESS, ACCURACY & COMPLETENESS

TO HOSPITALS OR ER

Timeliness, Accuracy and Completeness of Info

Info from Primary Care Physician

80%

70-92%

NEVER

3%

36-46%

SELDOM

12%

TIMELINESS

96%

ACCURACY

96%

ALMOST ALWAYS

35%

COMPLETENESS

89%

SOMETIMES

43%

ALWAYS

7%

© 2015 by Blue Cross of Idaho, an independent licensee of the Blue Cross and Blue Shield Association

Medical Management Managed Health Care/Review, Preadmission/Admission Certification, or Individual Benefits Management and Case Management

n 208-331-7535 n 800-743-1871 n Voice mail available after office hours and on holidays and weekends

Medicare Medicaid Coordinated Plan True Blue® Dual Special Needs Plan Hours:

n 8 a.m. - 9 p.m., MT seven days a week n Member Line Dual Special Needs Plan: 888-495-2583

n Waiver Providers Support Line: 866-588-6174

Blue Cross of Idaho Help Desk

Electronic Billing Errors, Error and Acceptance Reports

n 8 a.m. – 5 p.m. MT (Monday – Friday), n 888-BCI-EDIA, 888-224-3341 or 208-331-8817

Provider Contact Center for Commercial and Medicare Advantage

Benefits, Coverage and Authorization

n 8 a.m. – 5 p.m. MT (Monday, Tuesday, Thursday, Friday) 8:30 a.m. – 5 p.m. MT (Wednesday)

n208-286-3656 or 866-482-2250

Post-service claim questions log onto our secure website at bcidaho.com and select Contact Us.

External Provider Relations – Questions regarding website applications such as electronic billing, eligibility, claims, authorizations, internet services or requests for FREE on-site training

n 866-283-5723 or 208-286-3602

Ext. 8309: Jamie Hunihan – City of Boise, St. Lukes Health Systems statewide. Counties: Boise, Canyon, Gem, Payette

Ext. 8307: Kathy Brock, CPC-P – Counties: Adams, Benewah, Bonner, Boundary, Clearwater, Idaho, Kootenai, Latah,

Lewis, Nez Perce, Shoshone, Valley and Washington

Ext. 8308: Diane Mortensen, CPC – Cities: Eagle, Garden City, Kuna, Meridian, Star. Counties: Blaine, Butte, Camas,

Cassia, Custer, Elmore, Gooding, Jerome, Lemhi, Lincoln, Minidoka, Owyhee and Twin Falls

Ext. 7032: Angie McCormick, CPC – Counties: Bannock, Bear Lake, Bingham, Bonneville, Caribou, Clark, Franklin,

Fremont, Jefferson, Madison, Oneida, Power and Teton

Any Questions?

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