BlueBenefits Work. Memphis

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1 Photo: left to right - Amy McLean, Le Bonheur community health services manager; Johnsie Wallace, BCBST regional manager Provider Relations; William Phillips, Le Bonheur VP community outreach; Meri Armour, President CEO Le Bonheur Children s Medical Center; Calvin Anderson, BCBST VP Federal and Community Relations and Dr. Robert Yates, regional medical director BCBST were at the check presentation. BlueCross Funds Fit Schools Program in A new community health initiative to improve the overall health of children was launched last year by Le Bonheur Children s Medical Center and funded by the BlueCross BlueShield of Tennessee Health Foundation. The three to five-year Fit Schools program will focus on four West Tennessee school districts to promote good nutrition and increased physical activity in an effort to decrease childhood obesity.

2 Plan to Attend a Group Administrator Workshop in March Managing your company s human resources is a difficult assignment, and that s why BlueCross BlueShield of Tennessee invites you to attend a free workshop to help make your job a little easier. We especially encourage new group administrators and those new to BlueCross BlueShield of Tennessee to attend. Workshops begin at 7:45 a.m. and end about 11:30 a.m. Enjoy a complimentary continental breakfast and meet some of our staff who can help you answer some specific questions about administering your health plan. Included on our upcoming are presentations on: eligibility and enrollment clarifications, the billing cycle, the national BlueCross network, life insurance administration made easy and updates regarding our products. Please review our schedule of workshops and if you re interested in attending, please contact Norma Cupp at norma_cupp@bcbst.com. Group Administrator Workshop Dates & Locations in Your Area March 11 Fogelman Executive Conference Center, University of March 13 Jackson Doubletree

3 NEW Personal Health Statement Makes Reviewing Health Care Expenses Easy Perfect Compliment to Consumer-Directed Health Care Your employees will be able to review their health care expenses at a glance with the new Personal Health Statement (PHS). Details also show the total savings and value members received from plan discounts and benefits paid by their health plan. Members can use the Personal Health Statement to: Review 2007 health care spending and savings. Check routine expenditures and plan ahead for any similar 2008 expenses. Evaluate spending and care needs like a consumer and make smart decisions on health care and spending. Prepare taxes especially for members with a Health Savings Account or Health Reimbursement Account, or who have had significant medical expenses last year. The Personal Health Statement Details Available to all members in March, the PHS shows total annual health spending and savings, broken out by the member s applicable medical, prescription and dental coverage, if a member has all three. It also lists wellness programs or health improvement plans members used in the prior year, or those available now. Finally, the statement includes an individual listing of all claims processed by BlueCross BlueShield of Tennessee during the previous year. As the demand for Consumer-Directed Health Care plans grows, the Personal Health Statement will be the perfect tool to help members track their previous spending and plan for the future.

4 Proper Oral Care is Imperative for Pregnant Mothers The National Academy of Sciences Institute of Medicine reported that pre-term births are up 30 percent since Other scientific evidence indicates that women with periodontal disease are now nearly eight times as likely to have a pre-term delivery. Understanding the importance of oral care during pregnancy can help reduce the chance for pre-term births and minimize health care costs. Not long ago, pregnant women were told to avoid going to the dentist. However, research now suggests that hormonal changes in pregnant women place them at a greater risk for gum disease during their pregnancy. The bacteria from gum disease can lead to premature babies and increases the chance of toxemia in expectant mothers. While women should definitely tell their dentist that they are pregnant and avoid X-rays, it is very important that pregnant women continue to see the dentist every six months. A dentist s regular cleanings can help avoid gum disease or if gum disease exists a dentist can help minimize its severity and keep it from worsening during pregnancy. Pregnancy puts you at greater risk for gum infections and taking good care of your mouth will help you have a healthy, full-term baby.

5 Information About Massachusetts Health Notification for Mass. Residents If you have employees living in Massachusetts, you need to be aware that the Massachusetts Health Act requires residents in that state to provide proof of insurance with their personal state tax returns. In midjanuary we sent a letter to Massachusetts residents who had BCBST medical coverage as of the end of Please see the language of the letter below: 2007 Form MA 1099-HC Individual Mandate Massachusetts Health Care Coverage IMPORTANT - KEEP THIS FORM FOR YOUR RECORDS. Our records show one or more members below lived in the state of Massachusetts sometime during the 2007 calendar year. You may need the information from this form if you are required to file a Massachusetts personal income tax return. Call us if you have any questions about the information on this form. You can reach us at Additional Information: The Department of Revenue created a Health Insurance section to their Web page to explain the requirements for reporting health insurance information. This section can be viewed at

6 Over 500 Providers Utilize Real Time Claims Adjudication With more than 500 doctors using BlueCross BlueShield of Tennessee s Real Time Claims Adjudication since its introduction a little over a year ago, the new consumer tool has been a major success. The tool allows members to know what their actual cost is before they leave the doctor s office. This quick information is especially helpful for our members with Consumer Directed Health Care Plans. The consumer tool can be used to: Estimate member liability before receiving treatment; Determine accurate member costs at the point of service through Claim Submission and Claim Estimation online in real-time; Reduce administrative hassles such as balance billing or refunds; and Reduce confusion at the provider s office. Real Time Claims Adjudication has received very positive comments from doctors and their patients. Most of the feedback has praised the speed, accuracy and reduced paperwork for all involved. Real Time Claims Adjudication is not available at this time for BlueCare /TennCareSelect, BlueCard, Cover Tennessee, Federal Employee Program (FEP) or Medicare. At your next appointment, ask your doctor about BlueCross BlueShield of Tennessee s Real Time Claims Adjudication.

7 Rules Enhanced for Rehire Provision In an effort to prevent potential customer service issues for rehired employees not already in our system, we have improved our process for administering the rehire provision. This new process will ensure that the new hire eligibility waiting period will be waived even if the employee did not have previous insurance coverage with the BlueCross BlueShield of Tennessee group. The employee must be rehired within the rehire provision timeframe and have had prior coverage at any time during his/her past employment with the given group. If the employee was not previously covered by BCBST within the given group, a letter from the group detailing the employee s previous employment and insurance coverage should be submitted with the application. The letter should: Accompany the paper application or be faxed at the time an electronic application is submitted Be signed and dated by the Group Administrator Include the employee s previous employment start and end dates Include the prior insurance carrier name and the coverage start and end dates.

8 BCBST Offers Volunteers and Donations for Church Health Center BlueCross BlueShield of Tennessee volunteers took time out to assist the Church Health Center with addressing, stamping and sending their holiday cards. The Church Health Center in has provided care for more than 50,000 patients of record since opening in They are the largest clinic in Tennessee providing quality, affordable health care for working, uninsured people and their families. In addition, the BlueCross BlueShield of Tennessee Community Trust contributed $10,000 to assist the clinic.

9 Tennessee Reduces Dependence on Prescription Medication The number of pill bottles in Tennesseans medicine cabinets has decreased. According to Novartis, a world-leading pharmaceutical company, Tennessee has lost its long-held title of top prescription drug use state to West Virginia, which averages 17.4 prescriptions per capita. Coming in at No. 2, the Volunteer State averages 16.9 prescriptions per year for each man, woman and child. That s a 6.6 percent decrease from last year s 18.1 prescriptions. Additionally, the growth in per capita spending for prescriptions in Tennessee is dramatically less than the U.S. average. Where Tennessee s per capita spending grew by 7.2 percent to $1,272.94, spending at the national level increased 18.8 percent to $ In West Virginia spending grew by 21.7 percent. BlueCross BlueShield of Tennessee will continue to educate members about alternate over-the-counter options and promote healthier lifestyles to reduce the use of prescription drugs. These efforts help reduce costs for your company and for your employees.

10 A Better DentalBlue for You and Your Employees in 2008 Now that 2008 is well under way you can count on BlueCross BlueShield of Tennessee for your dental products. All fully-insured dental groups with 2008 effective dates will have implant coverage added. Implants are no longer an experimental service and can many times be more cost effective than a bridge. Anesthesia in conjunction with this service will also be covered. Other plan options are now available, please contact your broker or account manager for more information.