LSCC Employee Benefits: Updates and Information

 BCBSFL Updates and Information

BCBS Newsletters

June 2008

July 2008

7/28/08

Prime is increasing urgent shipping prices effective July 11. Currently, PrimeMail charges $9 for second business day shipping and $15 for
next business day shipping. Since its beginning in 2005, PrimeMail has maintained its current urgent shipping prices. However, the continuing rise in shipping and fuel expenses has prompted the review of current shipping pricing structure; resulting in the decision to increase the price of urgent shipping
requests. With fuel prices nearly doubling in the past three years, Prime will increase the price of urgent shipping from $9 to $15 for
second business day shipping and $15 to $22 for next business day shipping. Online messaging and Intelligent Voice Response (IVR)
messaging will be updated to reflect this change. Prime currently pays and will continue to pay 100 percent of standard shipping fees. The increase in urgent delivery pricing does not affect standard shipping pricing. Prime will reevaluate and communicate changes in shipping prices twice a
year. Prime will continue to monitor fuel prices and adjust shipping rates as prices fluctuate.
 

12/11/07

On November 30, MyRxHealth.com added new features designed to enhance the member experience. The new features include:
* Drug Cost Estimates
* Tracking PrimeMail orders sent via courier
* My Account - update account and PrimeMail® Profile information
Drug Cost Estimates
The Find Drugs & Pricing feature currently provides logged-in members with drug prices specific to their benefit design; the prices displayed are prices the member would expect see at their pharmacy on that day. As part of our November enhancements, a new feature, Drug Cost Estimates, allows visitors to look up estimated drug prices without logging in.
Some highlights of the Drug Cost Estimates feature include:
• Costs of multiple drugs may be calculated at once
1 Members may choose which retail pharmacy to view prices
2 Drug price estimates for PrimeMail are shown next to the retail price estimates
3 Generic equivalents of brand-name drugs are automatically displayed when available
4 Multiple methods of searching for drugs are available:
• Entering the first three letters of the drug name
1 Using an alphabetical search
2 Searching from a list of the top 50 drugs
(Please note that the prices shown in the Drug Cost Estimates feature are estimates only and may not accurately reflect pharmacy prices at the time of purchase. To receive the most accurate pricing information, members should log in and use the Find Drugs & Pricing feature.)
Link to Shipment Tracking
The Order Status feature currently allows members to view the processing status of their PrimeMail prescription. This feature has been enhanced to include a shipment tracking number for each PrimeMail order sent via courier. By clicking on the tracking number, members are taken directly to the courier's Web site to view the shipping status of their order. A link to the shipping company's home page is also provided on the Order Status Detail page.
My Account
The PrimeMail Profile is updated with a more comprehensive feature called My Account. This feature allows members to:
* View account information
* View and update PrimeMail contact information - mailing address, phone number, e-mail address
* Update and add new credit cards
Maintain web site username and password
 

11/28/07

A Healthy Savings Tips link has been added to the MyBlueServiceSM homepage! Members now have the option to view up to 15 tips on various topics, including:
* Save money and stay safe when you take medicine
* Learn about lower cost preventive services that can help you identify problems before they become serious and more costly
* Use lower cost options for non-emergency care, like speaking to a health coach or going to a local urgent/walk-in care center
Tips can be easily accessed on the internet at:
* http://www.bcbsfl.com/healthySavings/ (all members excluding State group)
 

7/25/07

Please see the attached PowerPoint presentation for BlueSolutions Benefit Changes (enhancements) Impacting All Existing BlueOptions - Plan A Members as of 7/1/07. A short summary of new enhancements is listed below:
* Removal of highest cost hospital tier (option 3 for hospitals)
* Coverage for inpatient rehabilitation for acute care conditions- there will be a 21 day limit - currently no coverage for inpatient rehabilitation under your current plan
* New lower cost share for e-visits of $10 copay - currently members pay office visit copay
* Addition of a 90 day retail RX benefit - member will pay 3 copays - currently member can only get a 30 day supply at retail pharmacies
The presentation is posted to the HR web page for your convenience.
The shortcut shown below will take you to a narrated tour of BCBSFL's website. Learn how to register, view benefits, update personal information, manage your account, and much more. www.healthink.com/florida/newsfromblue/PDF/Demo/0-Introduction.htm
 

7/24/07

Advanced Imaging UM program for BlueOptions - Plan A members
I wanted to provide you information regarding implementation of our Advanced Imaging Utilization Management Program for NetworkBlue(BlueOptions-Plan A) effective July 2, 2007. The BCBSF Advanced Imaging Utilization Management Program is designed to effectively manage non-emergency radiology services in an office or independent diagnostic testing center (IDTC). On March 1, 2007, a certified letter will notify NetworkBlue physicians and IDTCs of this new requirement. A follow-up letter with detailed program requirements and processes will be sent on May 1, 2007 to the same providers and IDTCs. Effective Monday, July 2, 2007, NetworkBlue (BlueOptions) physicians
and providers will be required to obtain prior authorization for any of the advanced imaging procedures designated under the program. The
following advanced imaging procedures will require pre-service authorization for determination of medical necessity when performed in
an office or IDTC:
* CT Scans
* MRIs/MRAs
* PET Scans
* Nuclear Cardiology Studies
Services rendered in an emergency room or hospital inpatient setting are not subjected to the pre-authorization program. Additional details will be forwarded on this program.

Custom Benefits Updates and Information

12/14/07

To: All Flex Plan Participants:
From: Custom Benefits Services
To begin with, our office upgraded our flex software. A new function this software allows is on the employee web site www.myflexonline.com. This web site provides a new claim form called "ice form." The area where the participant would locate the claim form is under "Request Payment."
The ice form will reflect all participant generated information. This new form allows the participant to input all claim information including the claim type. All expenses must be line itemized which is the same as what is to be completed on the other claim form obtained on www.ezflexplan.com/cbs. However, this form is somewhat different. Once the participant clicks print, the form is prepped for our system. However, like before the claim can not be processed until our office receives a copy of the claim form and receipts. These may be either mailed or faxed. Once our office receives the claim form and receipts, we input the claim ID # and the participants claim is automatically pulled into our system. The advantage for the participant is the claim is automatically placed into claims processing once it is brought up into the system. Having the information pulled up in to our system can also help to avoid delays in processing. Because, often we receive claims and cannot read the handwriting and this will delay the processing.
Yes, the other claim form may still be obtained at our web site www.ezflexplan.com/cbs. And, once on this web site, there is a link to the employee web site www.myflexonline.com. When a participant clicks to view their balance/account, it will take them to www.myflexonline. Again, the participant may go straight to the employee web site www.myflexonline.com or use the link through www.ezflexonline.com/cbs. Also, the employee web site allows the participant to track their claim item by item. This is another reason it is required to have expenses itemized on the claim form. It is also critical that participants keep a copy of their claim. This will serve well if they need to refer back to the claim in reference to a denied expense. Once a claim is processed, it is considered a dead claim and is placed in storage. Participants must keep a record of their expenses. We will not satisfy requests for copies of receipts. As stated before, the participant may track their expenses through the web site.
Please note: For the employee web site, the system now requires a birth date for the login information. This is a security measure that was not required in the old software. This may cause a little confusion for participants who have never accessed the site. Basically, when our office is contacted we will update their birth date and then they must wait 24 hours before attempting to access the site.
At this time, I just want to reiterate what is required on documentation submitted for reimbursement. All documentation submitted for reimbursement must reflect a Provider's name, service date, services rendered and patient responsibility. Cancelled checks and bank statements are not considered receipts. IRS wants to know when a participant incurred the expense, not when the expense was paid.
Also, credit card slips over $50.00 must reflect the services rendered. All receipts for Dermatology and Dental expenses must reflect the services rendered.
If the expense is for vitamins/supplements, a doctor’s letter of medical necessity is required. The letter must reflect a medical condition, state the name of the vitamins/supplements and state they are recommended as treatment of condition.
For Orthodontic requests, a copy of the financial agreement reflecting the monthly contract fee is required on the first claim.
Processing of claims will continue as usual. If the claim is received by Wednesday, it is processed that same week. If received after Wednesday, it is processed the following week. Disbursements are created on Fridays. If for any reason this schedule should change, we will contact the administrator.
One last item to remember is in reference to the flex extension. The IRS flex extension for your plan year is ending 12-31-07. Participants are allowed a 10 week extension to incur expenses which can go back to clear out a previous plan year balance. Expenses incurred between 1-1-08 and 3-15-08 may go back to clear out any 2007 account balance. The grace day deadline to submit the expenses for 2007, is April 30, 2008. Our software is set up to clear a previous account first. Please remember 2007 expenses cannot go forward to the 2008 account. Only expenses incurred between January 1, through March 15, 2008 can go backwards towards a 2007 balance.
If after reading this there are questions or concerns, please don't hesitate to contact Cindy at Custom Benefits either by calling 1-800-809-8161 or e-mailing.
I believe together if we can encourage the flex participant to utilize the web site to fullest extent and to adhere to the IRS regulations for submitting reimbursement requests, 2008 will be another great year for all involved.

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