Broker NEWSLETTER. Summer 2016

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1 Broker NEWSLETTER Summer 2016

2 Welcome With summer finally upon us, it s time to get out and enjoy the great outdoors. Whether it s a weekend camping trip in the mountains or time spent lakeside, it s a great time of year to get out and take advantage of the lifestyle that draws so many of us to live where we do. Amid all that outdoor recreating and assorted fun, we ll be gearing up for one of our busiest seasons, and this year there will be plenty of changes to keep us all on our toes. One of the changes that probably already caught your attention is our transition to our Online Enrollment Center for groups. The new OEC is an important tool that will help smooth the process of administering benefits while giving everyone greater visibility, flexibility and accuracy. Groups began transitioning to the new system earlier this year, but you can get more information on the roll out of the OEC in this issue. Another big change is found in our online cost transparency tool, CostAdvisor. Now, the tool allows you to search for even more services. You can get a preview of what s new in this issue, as well. You can also learn more about the award-winning Blue Cross of Idaho Customer Service Department and how you can help our customer advocates give you even better, faster service whenever you call. And speaking of our staff, you can find out a little more about some of the new faces who have joined our team. While changes can be daunting, remember that we re always here to help. We continue to be committed to adding value through customer-focused, innovative solutions. As always, our goal is to be the first and best choice for health insurance carriers when you are helping your clients find a plan that works for them. We appreciate your business! Terrie Havis Director, Broker Relations CostAdvisor Expands Searchable Procedures and Services Blue Cross of Idaho members can now use our online cost transparency tool, CostAdvisor to search cost estimates for four times as many healthcare procedures and services. Members can find estimates including out-ofpocket costs for more than 1,600 services. Here is just some of what s available: Ear tube insertion or removal Tubal ligation Vasectomy Skin cancer removal (MOHS surgery) Rotator cuff repair Carpal tunnel surgery Routine obstetric care Cataract removal CAT scans, MRIs, X-rays and ultrasounds from head to toe Knee or hip replacement EKGs, Stress Tests Chiropractic adjustments Back surgery including laminectomies Gallbladder removal Pacemaker implant CostAdvisor looks at how much members have already spent on their deductibles and other out-of-pocket costs, and estimates how much they will actually have to pay for procedures and services. And CostAdvisor is free our valued Blue Cross of Idaho members. For more information, or to log onto CostAdvisor, visit bcidaho.com/knowbeforeyougo. Coverage that fits

3 Calling Customer Service Calling an insurance company isn t usually considered a fun experience. This is why so many people call their trusted insurance advisors to do the leg work. At Blue Cross of Idaho, our customer advocates understand the role of brokers and are happy to help you resolve your client s issues. Please keep in mind that there are a few pieces of information that need to be verified in order to comply with HIPAA and protect the privacy of our members. Please remember the tips below when contacting the Blue Cross of Idaho Customer Service Department to ensure a quick, easy call: Per HIPAA, we must be able to verify the following information in order to allow you access to your client s information: Your name, identification and title, as applicable Blue Cross of Idaho member s name Enrollee ID number or date of birth Other information required for the particular situation Examples include giving us the healthcare provider s name, date of service, and billed amount regarding a question about how a claim was processed. As the broker of record, you have access to much of your client s information. Our customer advocates are able to quickly verify in the member s policy if you are the broker of record. If the customer advocate is unable to determine that you are the broker of record, he/she will connect you to someone on our Broker Relations team to further assist you. We typically are not able to update your client s information without his/her authorization. Examples include bank draft changes, billing or address changes, change in primary care provider, or requests to cancel a member s policy. You can always call us with the policyholder on the line to authorize these changes. We are unable to send you a client s EOBs, claim itemizations, etc. without verbal or written authorization from the member. You can find a member authorization form on the broker portal at bcidaho.com/brokers. The Blue Cross of Idaho Customer Service Department always strives to provide you the best experience possible. Please feel free to provide any feedback to brokerrelations@bcidaho.com.

4 Matt Schnug Joins Coeur d Alene Team The Blue Cross of Idaho team in North Idaho grew in March with the addition of Matt Schnug as the new district sales manager in Coeur d Alene. Matt has extensive experience working with small, large and selffunded groups, and more than 15 years of experience in the industry. He previously worked with Moda Health, based in Portland, Oregon, and was responsible for opening new markets in Alaska and Washington. It was the opening of the Washington market that took Matt and his family to the Spokane, Wash., area in We are excited to have Matt on board, and we re sure the Coeur d Alene market will benefit greatly. Welcome Tina Kodanko Blue Cross of Idaho welcomed Tina Kodanko to the sales team in February, as a sales consultant in the Meridian District Office. Tina brings with her 25 years of experience in the health insurance industry. She started her career at Blue Cross of Idaho in account management before spending 17 years at Regence Blue Shield of Idaho. She took a few years off to open her own small business. Tina is a long-time Idaho resident who has three grown children, Kelsey, Lauren and Jacob. We are thrilled to have her back at Blue Cross of Idaho. Blue Cross of Idaho bcidaho.com

5 Blue Cross of Idaho Looks at the Future There are many reasons why healthcare costs continue to rise, but one of the biggest ones is the way we deliver healthcare. We all want easy access to doctors and hospitals and the newest and most advanced treatments. The way our system works now, providers, hospitals and clinics are paid for the healthcare they provide. This is called fee-forservice, and is the way most care happens. But this system is flawed because the more services a provider bills for, the more he or she gets paid, rather than getting paid more for making people well. Now, health insurance companies are looking at ways to replace the fee-for-service system with one that rewards doctors when they make people better. As the price of care continues to rise, Blue Cross of Idaho is dedicated to finding new ways to reduce our members out-of-pocket costs while still bringing them the high-quality care from the providers they deserve. Contact Us Sales Office For individual business support...iss@bcidaho.com For group business support...groupsales@bcidaho.com Enrollment & Billing Enrollment applications for existing groups......groupapps@bcidaho.com Broker Customer Service Hotline For all non-sales customer service issues, i.e. billing, claim or benefit questions Member Customer Service CVS Health Rx Customer Care MA Broker Relations Hotline To order supplies and for product and compliance questions MA Broker Assist Line For eligibility, enrollment, and benefit questions To send enrollment applications... mapp@bcidaho.com MA Member Services Broker Relations... brokerrelations@bcidaho.com or For questions on training, appointments, commission or other issues

6 3000 E. Pine Ave. Meridian, ID Published by Blue Cross of Idaho by Blue Cross of Idaho, an independent licensee of the Blue Cross and Blue Shield Association. All rights reserved. No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement not take the place of the recommendations of your healthcare provider. Consult your physician before making major changes in your lifestyle or healthcare regimen. Blue Cross of Idaho makes no endorsements or warranties regarding any of the products and services included in this publication or its articles. Blue Cross of Idaho Welcomes New President and CEO Charlene Maher Charlene Maher took over the post of president and CEO on March 1, following the retirement former president and CEO, Zelda Geyer-Sylvia. Charlene has more than 20 years of health insurance experience in the fields of strategic planning and execution, new business development, operations and sales and marketing. Most recently, she was the chief marketing officer and senior vice president Commercial Sales at Emblem Health in New York from 2010 to 2015, where she had executive leadership responsibility for the profit and loss of the commercial market segment covering more than 3 million lives and $8 billion in revenue. Prior to her job there, Charlene was the vice president and general manager at Medica Health Plans, Inc., in Minneapolis, Minn. Charlene also has 15 years of experience with WellPoint, Inc., where she progressed to the executive position of vice president and general manager for the individual and family managed healthcare businesses for 14 Blue Cross Blue Shield states. She began her professional career as a registered nurse after receiving her bachelor of science in nursing from the University of Texas.