What's Inside:
Did You Miss Our Special Alert? | 2018 Underwriting Compliance Guidelines Updates | CVS/caremark™ Website Access for Members | Checks to Cover Out-of-Network Services Are Issued With EOBs | Capital Blue Spring Health Fair | 360° on Reform | 360° for Business |
|
| Did You Miss Our Special Alert? |
|
| 2018 Underwriting Compliance Guidelines Updates |
|
We’ve spruced up the underwriting guidelines to help you better manage your Capital BlueCross book of business.
Section VIII. New Group Enrollment Paperwork
Part I. 1. Ownership Tax Documentation was updated to clarify which documents are needed when multiple entities wish to combine.
Section XI. Paperwork Due Dates
The chart has been added back into the guidelines for 2018 effective dates. Capital BlueCross continues to stress the importance of clean paperwork for new and renewing groups at least 30 days prior to the effective date so we can give our mutual customers an exceptional group and member onboarding experience.
Section XII. Frequently Asked Questions
The geographic rating areas (GRAs) that apply to Small Groups using per member rate calculations have been added as an FAQ. | |
|
| CVS/caremark™ Website Access for Members |
|
Capital BlueCross members can log in to their secure account and access, without a second log in, the CVS/caremark member website. Using this fast and easy single sign-on service, members can fill a new prescription, order refills, review prescription history, locate pharmacies, and more!
When you spread the word, note that members who use Chrome or Firefox will get the optimal user experience. |
|
| On behalf of Capital BlueCross, CVS/caremark™ assists in the administration of our prescription drug program. CVS/caremark is an independent pharmacy benefit manager. |
|
| Checks to Cover Out-of-Network Services Are Issued With EOBs |
|
| Explanations of Benefits (EOB) for services performed by an out-of-network (OON) provider may include checks for members to cover the cost of those treatments. The FAQs below have been added to the EOBs to help proactively answer customer questions. |
|
|
|
What is this check?
This check is payment for the services shown on your Explanation of Benefits.
Who is it for?
The check is issued to the subscriber. It is the subscriber’s responsibility to pay the provider, along with any amounts not covered by Capital BlueCross, if not already paid.
What happens next?
Contact the provider if you need to arrange payment. Keep this stub for your records. |
|
|
|
| Capital Blue Spring Health Fair |
|
We encourage you and your clients to come out and visit the Capital Blue health and wellness centers’ spring health fairs! We’ll offer activities focused on physical, social, emotional, and spiritual health—perfect for some healthy mingling.
April 21, 11 a.m. – 1 p.m.
2845 Center Valley Pkwy, #404, Center Valley
April 28, Enola, 11 a.m. – 1 p.m.
4500 Marketplace Way, Enola |
|
| Introducing 360° for Our Members |
|
| We are pleased to introduce 360° for Our Members, a quarterly digital publication for our members, empowering them to make smarter, better decisions about their health, wellness, and medical care. Take a look inside! |
|
360° on Reform rounds up the latest news affecting the health insurance industry. This month's highlights include:
- HHS Opiod Summit
- Healthcare Cost Containment
- Conscience and Religious Freedom Division
- And more!
Go check it out! |
|
| | Capital BlueCross is an independent licensee of the BlueCross BlueShield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital BlueCross in its capacity as administrator of programs. This is an advertisement.
ECWC.V2 03.18
2500 Elmerton Avenue, Harrisburg PA | capbluecross.com | © 2018 Capital BlueCross All Rights Reserved.
Nondiscrimination and Foreign Language Assistance Notice |
|
|
|
|
