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LSCC Employee Benefits: Updates and Information
 
BCBSFL Updates and Information
BCBS Newsletters
BCBS Health Ed
Resource Guide
Update
on Extended Dependent Coverage Legislation for Dependent Children Ages 26-30
Member
Health Statement
Member Health
Statement FAQ's
Responsible Rx
program update
MyBlueService
Enhancements
BCBS Wellness News Monthly Newsletters
11/20/09 BCBSF has expanded Convenient Care
Clinics for BlueOption members with the addition of 47 Take Care ClinicsSM at
Walgreens locations throughout Florida.
For BCBSF, Take Care Clinics are considered Convenient Care Clinics. Members may
experience lower out-of-pocket costs when receiving care from these clinics,
depending on the structure of their benefits.
See attached for more information
4/21/09
MyBlueServiceSM is the online gateway to everything about a member's health plan
as well as all Blueprint for Health(r) self-service tools. Once a member
registers, MyBlueService is easy to access and use. Beginning April 20, members
will have single sign-on access to Mellon
(HSA), Health Dialog, MyRxHealth and Quest Diagnostics via MyBlueService. In
addition, single sign-on access to WebMD will be added
soon!
There are several enhancements planned for the April release of MyBlueService:
* Automatic registration at enrollment - New and renewing members (groups
and individuals) that provide a valid email address will now
receive an email and a link that will allow them to securely register for
MyBlueService.
* The auto registration process is for non-registered members, who are the
primary contract holder and have active health coverage for
either group or individual contracts.
* Only primary members can auto register, secondary members cannot.
* PHI (Personal Health Information) members will be excluded from the auto
registration process.
* Keep in mind that members can only be auto registered if they have
supplied us with their email address at enrollment.
* Once a member enrolls, they will be sent an email to their email address
on file. This email includes details for auto registration along with a secured
Web site link to complete the auto registration process.
* If members lose the email or have difficulty with the link, they can
always register as a first time user at
http://www.bcbsfl.com.
* The current method of enrollment and resetting a member's ID is still used
if members do not register using the automatic enrollment.
* Within MyBlueService, members will now have single sign-on access to
Mellon (HSA account information is now viewable as part of the
claims screen), Health Dialog, MyRxHealth and Quest Diagnostics.
* MyBlueService will allow group members to view online their contract and
endorsements and print these documents via pdf.
* On MyBlueService, members will have a new feature on the Member Health
Statement page which will allow them to generate and download customized
reports. Members will be able to apply filters by Member Name, Claim Type and
Date of Service.
The report names and meanings are as follows:
* Date of Service - Allows the member to create a report for one, more than
one or all family members based on a specific date range.
* My Cost - A report that illustrates claims with dollar amounts
contributing towards deductible and / or out of pocket expenses (e.g.,
copayments / coinsurance). *This does not include premiums or non-covered
items.
* My Deductible - Members can use this report to determine how quickly
they've met their deductible for the year
Via MyBlueService, members will have access to shopping tools for medications
and hospitals, health savings tips, engaging videos and
personalized messages
4/14/09
As of 4/1/09 Blue Cross and Blue Shield of Florida (BCBSF) has developed a
comprehensive oncology care management program. With a member-centric approach,
the Oncology Care Support Program is designed to help individuals to become
self-advocates in their own care by understanding their treatment options and
ways to prevent unnecessary complications. Participation in the program will
allow Care Management staff to offer one-on-one telephonic engagement with the
member and/or caregiver, and to collaborate with the member's physicians and
other providers.
The primary goals of the program are to provide physical and psychosocial
support to members through increased knowledge about their disease including
stages of their illness, decision-making related to treatment options and
management of side effects. The program will provide communication and support
as well as interventions to improve health outcomes and the continuity of care.
The BCBSF Oncology Care Support Team will consist of Care Management Medical
Directors and Care Coordination Registered Nurses. Nurses will perform an
assessment to identify the individual needs of the member diagnosed with cancer
including education of their disease and symptom management interventions. The
Care Coordination nurse will also provide care facilitation activities, such as
coordinating services ordered by the physician and medical cost management
activities ensuring proper use of resources.
Care Coordination Nurses are available 8:30am-5pm, M-F, 1-800-955-5692. Select
option 4, (BCBSF) for complex care support.
Member identification is enabled by our current Utilization Management and Care
Management programs as well as through authorization and claims data analysis.
Internally, Care Coordinators may identify members through concurrent review
activities, case management, or member outreach. Additional opportunities for
member identification for this program include authorization data, Health Risk
Assessments (HRA's), and predictive modeling tools.
Externally, members may be identified by the treating physician, primary care
physician, palliative care physicians, or by other medical facility staff.
Members may also be identified through self-referral (member/caregiver) or
employer group referral. The member's primary care physician or treating
physician will be notified of the member's participation in the Oncology Care
Management Program.
The Oncology Care Support Program allows for engagement of the member at any
point throughout the continuum of care. The program is available for active
BCBSF members for all lines of business (except FEP), who desire assistance and
support with their medical condition and coordination of their care. Members
actively engaged in hospice would not be eligible for participation.
Members referred to this program that do not meet eligibility criteria for
program enrollment will be referred for participation in other Care Management
Programs (i.e., Discharge Planning, Member Outreach, Complex Case Management,
etc.).
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
12/11/08
From Custom Benefits
regarding reimbursement claims.
All receipts, insurance EOB's, and statements submitted for flex claim
reimbursement must reflect a Provider's name, service date when expenses were
incurred, services rendered (type of service patient received) and charges for
the service rendered. Please remember when considering date of service it is the
date the actual service was rendered. The service date is not the payment date.
Cancelled checks, bank statements, credit card statements are not considered as
receipts. There may be times, when further substantiation of an expense could be
required. This may include a doctors letter of medical necessity. If a letter is
required, it must reflect a medical condition, state the item or items necessary
for treatment and state the item is recommended as treatment of condition.
As a reminder, if a flex claim is received by 5:00 pm Wednesday, which is the
cut off day, it is processed that same week. If received after this time, the
claim is processed the following week.
Participants can track their balances by visiting the employee flex web site -
www.myflexonline.com. If you have never visited, please log in as a New User.
This site provides 24/7 access to activity on your account. Participants may
view and track each claim expense being processed, as well as when a
disbursement has been created. You have access to the Internet Claims Entry
form. Once the form has been created and printed, the participant will need to
submit it along with receipts to our office either by fax or mail. Once we enter
the number off the form, the claim form is automatically downloaded into our
system. This helps in expediting the process of claims. Also on this site,
participants may view important plan year, FSA extension period (if it applies)
and grace day deadline dates. Please familiarize yourself with the site. It's a
great tool for managing your flex account.
Flex fund reimbursement is also available to all participants by using direct
deposit. Custom Benefits can fax a form to a participants or you may go to the
LSCC Forms and Information page (Custom Benefits Reimbursement Direct Deposit
Form) and print one. At this time, please let this serve as notice effective
January 1, 2009, Custom Benefits will no longer mail direct deposit notification
stubs for a direct deposit reimbursement. You may obtain direct deposit
reimbursement amount on the employee web site or through online banking with
your banking institution. All weekly flex reimbursements are updated in Custom
Benefits’ software usually by Friday night or Saturday morning.
In observance of the upcoming holidays, Custom Benefits will close on Wednesday,
December 24, 2008 and will re-open Monday, January 5, 2009.
If there are any questions or concerns that have not been addressed, please
e-mail (custombenserv@msn.com) or phone 800-809-8161.
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.
Other Information
For those with accounts
with AIG-Valic, please see the note from Pam Schmitz and the
attached statement in regard
to AIG-Valic developments. If you have questions/concerns about your Valic
account, please call Pam on her cell phone – 352-396-6927. As AIG-Valic’s home
office is in Houston, she is still having problems accessing email and voice
mail.
UF Lake Co Extension
Julie B.
England, Extension Agent I
University of Florida/IFAS Lake County Extension
1951 Woodlea RD
Tavares, FL 32778
julieeng@ufl.edu
352-343-4101 Phone
352-742-3999 x 2721 Direct Line
352-343-2767 Fax
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