February 2016

(Electronic distribution February 3, 2016)

View a printable PDF of this newsletter.

Beyond the ACO: Building a Better Health Care Reimbursement Model
The health care industry is at a crossroads in terms of how care is delivered. In his latest Huffington Post column, our enterprise Chief Medical Officer Dr. Stephen Ondra talks about a variety of approaches to “fee-for-value” provider reimbursement.

Blue Promise Video: Should We Be Concerned About the Zika Virus?
In this edition of our Blue Promise video, two BCBSTX medical professionals discuss the Zika Virus. The virus has been around for a long time but has become more prominent lately. Watch the video.

HEDIS Medical Record Review Requests
Every year our Health Plan Quality performance undergoes a HEDIS^® audit. As part of this audit, one or more of your patients may be randomly selected for medical record review. While we use claims data when possible, some of the measures require information from medical records.

Notices and Announcements
In this issue of the newsletter, we have an update on ICD-10 implementation resources that may help in your practice and information about our Behavioral Health Quality Improvement program. Get the details.

In Every Issue
BCBSTX is required to provide certain notices in all published correspondence with physicians and professional providers. For the latest updates, visit the News and Updates area of the BCBSTX provider website. Get started now on reviewing this month's articles.

Contact Us
View our quick directory of contacts at BCBSTX.

Update Your Contact Information
Accurate provider directories are an important part of providing BCBSTX members/subscribers with the information they need to manage their health.

To update your contact information,you should submit all changes at least 30 days in advance of the effective date of change. Please submit your correspondence via:

• fax: 972-231-9664
• mail: P.O. Box 650267, Dallas, Texas, 75265-0267

If your specialty, practice information/status or board certification is not correct on the BCBSTX Provider Finder^®, or if you would like to have a subspecialty added, please contact your Network Management office.

In addition, BCBSTX periodically identifies providers who have not submitted claims for a period of one year. We make an effort to contact each provider to confirm their information. If the provider does not respond, we will initiate a network termination. Similarly, BCBSTX will inactivate any tax identification numbers (TINs) under which there have been no claims submitted for a period of one year.

Blue Review is published for Blue Choice PPO^SM, HMO Blue Texas^SM, Blue Cross Medicare Advantage (PPO)^SM, Blue Advantage HMO^SM, Blue Premier and ParPlan contracting physicians and other health care providers. Ideas for articles and letters to the editor are welcome; email BlueReviewEditor@bcbstx.com.

The information provided in Blue Review does not constitute a summary of benefits, and all benefit information should be confirmed or determined by calling the customer service telephone number listed on the back of the member/subscriber ID card.

BCBSTX makes no endorsement, representations or warranties regarding any products or services offered by independent, third-party vendors mentioned in this newsletter. The vendors are solely responsible for the products or services they offer. If you have questions regarding any of the products or services mentioned in this periodical, please contact the vendor directly.

Blue Cross^®, Blue Shield^® and the Cross and Shield symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.