SPRING 215 New Website Look ad Feel Blue Cross of Idaho is lauchig a ew ad improved provider portal, tetatively set to lauch i Jue. You will still have the same tools, but a clea, ew look ad feel will make usig the website eve easier. The ew top avigatio feature allows you to see the tools you are already familiar with, while a additioal My Favorites feature i the avigatio bar o the right of the page allows you to bookmark pages. Each time you log i, the system recogizes you ad remembers your persoalized favorites list. oe TO oe FOR HEALTHCARE PROFESSIONALS As the ew provider portal lauch gets closer, we ll sed more iformatio ad details. If you eed ay help with the existig portal, please cotact your website traiers i our Provider Relatios Departmet.
New Commuicatios Pla Cuts Dow o Clutter Cosiderig that most of us are iudated by iformatio o a daily basis, Blue Cross of Idaho is chagig our provider commuicatio pla to streamlie our efforts while still givig you all the iformatio you eed. Begiig Jue 1, all commuicatios regardig cotractual issues, or that require a 3 6-day otificatio widow, will cotiue to be set via provider alerts. But commuicatios desiged to be iformatioal oly will be posted to the provider portal of our website every Moday i the ew Weekly News sectio. Each Moday, the previous week s otificatios will be available i the Forms & Resources/Provider Notificatios sectio of the provider portal, or by selectig the View All lik below curret otificatios. Please log oto our website, bcidaho.com/provider to view ay updated ews ad aoucemets from Blue Cross of Idaho. If you have further questios or eed additioal traiig o our website, cotact the provider relatios represetative i your area (PAP). New Faces Joh Welsh recetly joied Blue Cross of Idaho as a provider iformatio maagemet specialist. He became a certified professioal coder i 21 ad most recetly worked for Elks Rehab System doig billig, paymet postig, provider erollmet ad servig as charge master. He also previously worked at St. Luke s Regioal Medical Ceter as a systems aalyst. Joh ejoys stayig active ad sped as much time as possible outdoors with his wife ad four childre. The whole family loves to go hikig, skiig, paddle boardig, white water raftig ad fishig. Whe they are home, they ejoy gardeig. Joh is a big Boise State Uiversity sports fa who has bee at every home football game tailgatig with frieds ad cheerig o the Brocos for may years. Mady Chug joied Blue Cross of Idaho as a provider iformatio maagemet specialist. I the past, Mady has spet time doig admiistrative work ad extesive customer service. She ejoys spedig time readig ad goig o ature walks. Noelle Bruce retured Blue Cross of Idaho i March as a provider etwork maagemet specialist. Noelle has worked with Blue Cross of Idaho as well as Regece Blue Cross Blue Shield of Orego i the past. She has extesive customer service, frot-ed hospital ad cliic maagemet experiece, ad brigs extesive kowledge of operatio of healthcare provider practices. Noelle is lookig forward to furtherig the relatioships betwee Blue Cross of Idaho ad the various healthcare provider commuities she has already established. She is also excited to focus her efforts o helpig facilitate, streamlie ad optimize the trasformatio of the market place to help reduce the risig costs of healthcare. Outside of work, she loves the outdoors ad everythig Idaho has to offer from campig, water ad sow skiig, fishig, golfig ad moutai bikig. 2
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Blue Cross of Idaho Mobile App We are pleased to aouce that the ew Blue Cross of Idaho mobile app for smartphoes was released o Moday, March 23. The mobile app allows members to take charge of their healthcare isurace iformatio while o the go. Users ca access their key health isurace iformatio wheever ad wherever they eed it, givig them the freedom of always havig their most vital isurace iformatio at the tips of their figers. The ew app allows users to: Search for doctors, cliics or hospitals by ame, locatio or specialty. Search for urget care closest to where they are. Sig i to view details about specific beefits. See progress toward their yearly deductible. View member ID cards for the member ad ay depedets. Email or fax member ID cards directly to doctors or care providers. Get cotact iformatio ad drivig directios for doctors, care providers or urget care. The app is desiged for Blue Cross of Idaho members, ad requires users be registered members at members.bcidaho.com to use all the features available o this app. Members ca use their logi iformatio (userame ad password) to access the full features of the app. But eve without sigig i, app users will still be able to search for doctors ad urget care. The mobile app is free to dowload ad is available at both the Apple App Store ad Google Play. Lear more about the app at bcidaho.com/mobileapp. Idividual Email Addresses Now Required I order to comply with HIPAA requiremets, offices usig a shared email address to access the Blue Cross of Idaho provider portal will have to update their accouts so each registered user has a uique email address. Idividual email addresses ot oly provide better safeguards for persoal health iformatio ad bak accout data, but they help streamlie our provider portal while allowig users to reset their accout passwords more securely. Registered users must have idividual email addresses associated with their accouts o later tha Friday, May 1. After that date, ay accouts with shared addresses will be deactivated ad deleted. Please remember that ayoe who is also a Blue Cross of Idaho member caot use the same email address associated with his or her olie member accout. The email address liked to a provider portal accout caot be associated with ay other Blue Cross of Idaho accout. To update email addresses, go to bcidaho.com ad follow the istructios below: Log i to the provider portal Select Accout Maiteace i the left avigatio Select Edit ext to each users ame to update the email address If you have ay questios, please cotact your exteral provider relatios represetative for assistace. (PAP) 4
Survey Results Show Opportuities for Improvemet IN THE FALL OF 214, Blue Cross of Idaho coducted a olie survey of practitioers to collect iformatio for cliical quality ad member safety improvemet efforts. The survey was desiged to help with cotiuity ad coordiatio of medical care across the etwork. The goal was to collect iformatio from primary care practitioers (PCPs) ad specialists about the timeliess, accuracy ad completeess of iformatio they receive about their patiets i differet settigs, ipatiet ad ambulatory. Through the survey, PCPs reported that they seldom or ever receive iformatio from specialists or hospitals approximately 46 percet to 64 percet of the time. But the PCPs had a very differet opiio about the usefuless of the iformatio they sed to specialists, hospital staff or ER staff. More tha 8 percet felt that they always or almost always sed useful iformatio to specialists, ad 36-46 percet felt they always or almost always sed useful iformatio to the hospital or ER. More tha 8 % of PCPS felt they ALWAYS sed useful iformatio Coversely, specialists reported that they sometimes receive useful iformatio approximately 43 percet of the time, ad almost always do so 35 percet of the time. Specialist reported that they always receive useful iformatio oly 7 percet of the time. PCPs reported overall satisfactio with the accuracy ad completeess of iformatio from hospitals, specialists ad acillary providers whe they receive it, however, the timeliess of iformatio was a area that showed potetial eed for improvemet. PCPs stated that the iformatio received met or exceeded their expectatios oly 7-92 percet of the time. The survey did ot defie timely, or accuracy or completeess. Fially, specialists reported that they sometimes receive useful iformatio from PCPs 43 percet of the time, seldom 12 percet of the time, ad ever just 3 percet of the time. Timeliess, completeess ad accuracy of iformatio met or exceeded expectatios for timeliess 96 percet of the time, were accurate 96 percet of the time ad were complete 89 percet of the time. The resposes from PCPs ad specialists provided sufficiet iformatio to idetify several areas for improvemet. PCPs reported that they eeded more iformatio from hospitals for patiet admissios ad ER visits, ad they, too, felt timeliess could be better. Additioally, while PCPs felt the iformatio they sed is useful, specialists did ot share that view. Ofte, the reaso for a specialist cosultatio is ot evidet i the iformatio received from PCPs. Overall, specialists eed more details o why the member was referred, while PCPs eed more follow-up iformatio after the patiet visited the specialist. Blue Cross of Idaho would like to improve the cotiuity ad coordiatio of care. We hope this serves as the begiig of a ogoig dialogue for everyoe to share best practices ad improve the timeliess ad cotet of shared iformatio. 5
Survey Results Show Opportuities for Improvemet cotiued Ifo from Primary Care Physicia 8% 36-46% 43% 35% 3% 12% 7% TO SPECIALISTS TO HOSPITALS OR ER NEVER SELDOM SOMETIMES ALMOST ALWAYS ALWAYS Primary Care Physicia felt it was successful always or almost always Specialist felt ifo was useful Timeliess, Accuracy ad Completeess of Ifo 7-92% 96% 96% 89% TIMELINESS, ACCURACY & COMPLETENESS From Hospital/Specialist to Primary Care Physicia TIMELINESS ACCURACY From Primary Care Physicia to Specialist/Hospital COMPLETENESS 6
Ay Questios? Medical Maagemet Maaged Health Care/Review, Preadmissio/Admissio Certificatio, or Idividual Beefits Maagemet ad Case Maagemet 28-331-35 8-743-1871 Voice mail available after office hours ad o holidays ad weekeds Medicare Medicaid Coordiated Pla True Blue Dual Special Needs Pla Hours: 8 a.m. - 9 p.m., MT seve days a week Member Lie Dual Special Needs Pla: 888-495-83 Waiver Providers Support Lie: 866-588-6174 Blue Cross of Idaho Help Desk Electroic Billig Errors, Error ad Acceptace Reports 8 a.m. 5 p.m. MT (Moday Friday), 888-BCI-EDIA, 888-224-3341 or 28-331-8817 Provider Cotact Ceter for Commercial ad Medicare Advatage Beefits, Coverage ad Authorizatio 8 a.m. 5 p.m. MT (Moday, Tuesday, Thursday, Friday) 8:3 a.m. 5 p.m. MT (Wedesday) 28-286-3656 or 866-482-22 Post-service claim questios log oto our secure website at bcidaho.com ad select Cotact Us. Exteral Provider Relatios Questios regardig website applicatios such as electroic billig, eligibility, claims, authorizatios, iteret services or requests for FREE o-site traiig 866-283-5723 or 28-286-362 Ext. 839: Jamie Huiha City of Boise, St. Lukes Health Systems statewide. Couties: Boise, Cayo, Gem, Payette Ext. 837: Kathy Brock, CPC-P Couties: Adams, Beewah, Boer, Boudary, Clearwater, Idaho, Kooteai, Latah, Lewis, Nez Perce, Shoshoe, Valley ad Washigto Ext. 838: Diae Mortese, CPC Cities: Eagle, Garde City, Kua, Meridia, Star. Couties: Blaie, Butte, Camas, Cassia, Custer, Elmore, Goodig, Jerome, Lemhi, Licol, Miidoka, Owyhee ad Twi Falls Ext. 732: Agie McCormick, CPC Couties: Baock, Bear Lake, Bigham, Boeville, Caribou, Clark, Frakli, Fremot, Jefferso, Madiso, Oeida, Power ad Teto 215 by Blue Cross of Idaho, a idepedet licesee of the Blue Cross ad Blue Shield Associatio 7