October 2010www.ibx.com/providers

Articles designated with an orange arrow include notice of changes ►or clarifications to administrative policies and procedures.

Inside this edition CREDENTIALING

New email address replaces the Network Credentialing Support ►Services Hotline

BLUECARD®

Fall 2010 edition of ● Inside IPP now available

ADMINISTRATIVE Submit the ● Initial Maternity Patient Questionnaire for early outreach to our pregnant members

PRODUCTS Upcoming 2011 Medicare Advantage HMO and PPO benefits ►changes Important information about the new Blue Cross ► ® Blue Shield® Medicare Advantage PPO Network Sharing program

BILLING Change to member copayment applicability for second inpatient ►admissions within ten days New professional fee schedules and revised reimbursement ►for all Delaware and Maryland PCPsLaboratory services reminder ● Revised capitation rates and $0 copayment for certain preventive ►servicesEmergency room follow-up care reminder ● Enhancements to the interest payment process begins ►mid-October 2010

MEDICALPolicy notifications posted as of September 20, 2010 ►Our policy on private duty nursing ► Coverage position change on ESWT for musculoskeletal ►conditions Use of modifier -25 when reporting E&M services with ►chemotherapy administration and dialysis codesPolicy reminder regarding utilization review decisions ●Two new components for precertification ►

NAVINET ®

How referrals affect KPOS members’ coinsurance for services ►requiring preauthorization Clarification: Authorization submission requirements through ►NaviNet

PHARMACYAnnual Synagis ● ® (palivizumab) distribution program

QUALITY MANAGEMENTQuality ranking for primary care physician offices ●

HEALTH AND WELLNESSSeasonal flu vaccine recommendations ► Connections ● SM wants to hear from you Connections ● SM Health Management Programs: Supporting your patients, our members

Annual Synagis® (palivizumab) distribution program page 15

Models are used for illustrative purposes only. Some illustrations in this publication copyright 2010 www.dreamstime.com. All rights reserved.

Independence Blue Cross offers products directly, through its subsidiaries Keystone Health Plan East and QCC Insurance Company, and with Highmark Blue Shield — independent licensees of the Blue Cross and Blue Shield Association.

The Blue Cross and Blue Shield names and symbols, BlueCard, and Baby BluePrints are registered marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans.

This is not a statement of benefits. Benefits may vary based on state requirements, Benefits Program (HMO, PPO, Indemnity, etc.), and/or employer groups. Providers should call Provider Services for the member’s applicable benefits information. Members should be instructed to call the Customer Service telephone number on their ID card.

The third-party websites mentioned in this publication are maintained by organizations over which IBC exercises no control, and accordingly, IBC disclaims any responsibility for the content, the accuracy of the information, and/or quality of products or services provided by or advertised in these third-party sites. URLs are presented for informational purposes only. Certain services/treatments referred to in third-party sites may not be covered by all benefits plans. Members should refer to their benefits contract for complete details of the terms, limitations, and exclusions of their coverage.

NaviNet® is a registered trademark of NaviNet, Inc.

An affiliate of IBC holds a minority ownership interest in NaviNet, Inc., an independent company.

FutureScripts® and FutureScripts® Secure are independent companies that provide pharmacy benefits management services.

Magellan Behavioral Health, Inc., an independent company, manages mental health and substance abuse benefits for most IBC members.

Partners in Health UpdateSM is a publication of Independence Blue Cross and its affiliates (IBC), created to provide valuable information to the IBC-participating provider community. This publication may include notice of changes or clarifications to administrative policies and procedures that are related to the covered services you provide in accordance with your participating professional provider, hospital, or ancillary provider/ancillary facility contract with IBC. This publication is the primary method for communicating such general changes. Suggestions are welcome.

Contact Information:

Provider CommunicationsIndependence Blue Cross1901 Market Street 35th FloorPhiladelphia, PA 19103

provider_communications@ibx.com

John Shermer Managing Editor

Charleen BaseliceProduction Coordinator

For articles specific to your area of interest, look for the appropriate icon:

Professional

Facility

Ancillary

Keystone Health Plan East, Personal Choice®, Keystone 65 HMO, and Personal Choice 65SM PPO have an accreditation status of Excellent from the National Committee for Quality Assurance (NCQA).

Please complete all prior authorization forms in their entiretyWhen completing a prior authorization form, please be sure to explain why the medication is medically necessary for your patient. If your form contains insufficient information, it may be returned to you or the request may be denied.

If you have any questions, please contact your Network Coordinator.

We have created a new online request form to streamline the ordering of your office supplies, such as provider manuals and directories and maternity questionnaires. Orders are normally shipped within 24 hours and should arrive to you within 3 – 5 business days.

To ensure that your request is sent to the proper location, you will need to provide some basic office information including your NPI, mailing address, and phone number. You also have the option to sign up to receive email notifications that provide you with the latest information, including when a new edition of Partners in Health Update is available, and news alerts.

The Provider Supply Line online request form is available on our website at www.ibx.com/providersupplyline.

Please note that the Provider Supply Line is not able to assist with claims-related questions, including supplying claim forms, authorization or eligibility requests, issues using the NaviNet® web portal, or credentialing information. Please contact Customer Service or your Network Coordinator to assist you with these types of inquiries.

Request your office supplies online

Reminders....

October 2010 | Partners in Health UpdateSM 3 www.ibx.com/providers

Credentialing

Quick tips for out-of-area

claims processing

Improve your claims experience

by following these helpful tips.

Requesting medical

records provides

resolution in BlueCard®

claims issues

Read about the role of medical

records in claims resolution.

HIPAA 5010 requirements

and objectives for

provider offices

Find out about the primary

objectives for the conversion

to HIPAA 5010 and when the

requirements must be met.

Claims processing results

for 2009

Learn about last year’s claims

processing results.

I N S I D E T H I S I S S U E

2

F A L L 2 0 1 0

www.ibx.com/providers

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4

Highlights of the BlueCard® provider

education seminars

In June, we hosted two ancillary provider education seminars to review

topics such as eligibility, precertification/preauthorization, problem

resolution, and BlueCard updates. The seminars also included provider

satisfaction improvement initiatives, a NaviNet® web portal demonstration,

and a detailed presentation that included the information that follows.

Approximately one out of three Americans (32.2 percent) receive their

health insurance through a Blue Cross® Blue Shield® Plan, and about

18 percent of Blue Plan members residing in Southeastern Pennsylvania are

out-of-area members of other Blue Plans. This high utilization reinforces

the need to continuously expand and improve our relationships with

participating providers.

Improving the provider experience with the BlueCard Program is a goal

of all Blue Plans. Ongoing provider satisfaction surveys to gauge provider

satisfaction with the BlueCard Program are conducted by the Blue Cross

and Blue Shield Association (BCBSA), an association of independent Blue

Cross and Blue Shield plans.

The Blue Plans, in an active effort to improve the provider experience with

BlueCard, have implemented technology enhancements to facilitate timely

resolution of provider claims appeals.

Ongoing Plan partnerships to enhance provider satisfaction, along with

collaborative efforts with local hospital and associations on a regular basis,

are initiatives currently in place. In the future, more focus will be placed

on non-acute care institutional providers. We are working with other Blue

Plans in our region to develop strategies that better support providers.

continued on page 2

4

The fall 2010 edition of Inside IPP: An Inter-Plan Programs Publication is now available and features the following articles:

Highlights of the BlueCard provider education seminars ●Quick tips for out-of-area claims processing ● Requesting medical records provides resolution in BlueCard ●claims issuesHIPAA 5010 requirements and objectives for provider offices ●Claims processing results for 2009 ●

Visit www.ibx.com/insideipp to read this edition of Inside IPP as well as access a complete archive of past editions. To request a paper copy through the Provider Supply Line, go to www.ibx.com/providersupplyline or call 1-800-858-4728.

Inside IPP is a newsletter intended to increase provider awareness of and satisfaction with the BlueCard Program. The publication introduces new initiatives related to BlueCard processing and highlights plans for improvement.

Fall 2010 edition of Inside IPP now available

BlueCard®

Effective November 1, 2010, the Network Credentialing Support Services Hotline (215-241-4120) previously designated for requesting your contract and billing registration forms, will be replaced with an email address, Application_Requests@ibx.com. Providers interested in participating in our network are responsible for notifying IBC upon completion of their Council for Affordable Quality Healthcare (CAQH) credentialing form. Once the form is completed, providers should notify the Network Credentialing Support Services Department using the email indicated above. Please be sure to include the following information:

practitioner’s name ●practitioner’s mailing address ●practitioner’s office address ●practitioner’s specialty ●practitioner’s CAQH ID number ● contact person’s name, telephone number, and email address ●

A contract and billing registration form will then be sent to the provider upon receipt of the email. These forms must be signed and returned to IBC. This new email address may also be used for assistance with obtaining a CAQH ID number.

As communicated in previous articles, IBC has mandated the use of the CAQH electronic credentialing application for new providers. The CAQH electronic credentialing application is free to providers and available on the CAQH website at https://upd.caqh.org/oas. Providers without Internet access should contact Customer Service at 1-800-ASK-BLUE.

New email address replaces the Network Credentialing Support Services Hotline

administrative

On March 23, 2010, President Barack Obama signed the federal health care reform act into law. With the passing of this bill, IBC is adjusting our Medicare Advantage HMO and PPO benefits to align with the current legislature as we move to implement reform. For example, we are decreasing members’ total out-of-pocket costs, which will provide more cost-effective health care coverage.

Please look for an article in the November edition of Partners in Health Update that will detail the significant benefits changes that are effective January 1, 2011.

Upcoming 2011 Medicare Advantage HMO and PPO benefits changes

ProduCts

Submit the Initial Maternity Patient Questionnaire for early outreach to our pregnant membersRegistering maternity members into our Baby BluePrints® high-risk perinatal program is imperative for early outreach. Our goal is to reach those members identified as having risk factors within their first trimester and to improve maternal-child outcomes.

The Initial Maternity Patient Questionnaire should be mailed to IBC immediately following the first prenatal visit to ensure timely registration into this program. All participating obstetric providers should complete this questionnaire with the pregnant member on her first prenatal visit so she will be screened as well as registered into Baby BluePrints.

The program offers members many benefits, such as educational materials and reimbursements for parenting classes, lactation consultants, and breast pumps. Additionally, our obstetric nurses offer case management to members who need help with such diagnoses as:

gestational diabetes mellitus ●pregnancy-induced hypertension ●preterm labor ●hyperemesis gravidarum ●

Please remind your staff to send in the registration questionnaire immediately after the first prenatal visit. Member registration into the program and prenotification for delivery will be completed at the same time.

You can request Initial Maternity Patient Questionnaires and postage-paid return envelopes by using our new online order form at www.ibx.com/providersupplyline or by calling the Provider Supply Line at 1-800-858-4728.

October 2010 | Partners in Health UpdateSM 4 www.ibx.com/providers

ProduCts

October 2010 | Partners in Health UpdateSM 5 www.ibx.com/providers

Important information about the new Blue Cross® Blue Shield® Medicare Advantage PPO Network Sharing programEffective for dates of service beginning January 1, 2011, IBC will be required by the Blue Cross and Blue Shield Association (BCBSA), an association of independent Blue Cross and Blue Shield plans, to participate in the BCBSA national Medicare Advantage PPO Network Sharing program and accept Medicare Advantage PPO enrollees from other Blue Cross Blue Shield Plans who travel or reside in our 5-county Philadelphia service area as our local members. Similar to the current BlueCard® Program for commercial Blue Cross Blue Shield PPO Plans, this national BCBSA initiative enables enrollees in one Blue Cross Blue Shield Medicare Advantage Plan to obtain health care benefits and services from participating Blue Cross Blue Shield Plan providers while traveling or living in another Blue Cross Blue Shield Plan’s service area.

How this affects participating providersAs a participating provider, you will be expected to provide services to these Blue Cross Blue Shield Medicare Advantage PPO plan enrollees who present to you for treatment as you would any other Blue Cross Blue Shield Medicare Advantage PPO member.

Facility providers

IBC will continue to process participating provider claims for covered facility services (e.g., hospital, skilled nursing facilities, ambulatory surgery centers, renal dialysis) for these Blue Cross Blue Shield Medicare Advantage PPO enrollees. For admissions on or after January 1, 2011, you will be paid the contracted rates for covered services for these members. For more information on claims submission, please refer to the Facility Payer ID grid on our website at www.ibx.com/edi.

Professional and ancillary providers

For professional and ancillary providers who submit claims on the CMS-1500 claim form or through the 837P transaction, your contract will be amended to cover your provision of services to these Blue Cross Blue Shield Medicare Advantage PPO enrollees and claims for services rendered to them. You should continue to submit commercial BlueCard claims to Highmark Blue Shield, as this process will not change. IBC will process only Blue Cross Blue Shield Medicare Advantage PPO claims.

For Blue Cross Blue Shield Medicare Advantage PPO claims that span dates of service from 2010 into 2011, you will be required to split the claim for billing purposes. Claims with dates of service up to December 31, 2010, should continue to be submitted to Highmark Blue Shield. For information on where to submit claims for dates of service on or after January 1, 2011, please refer to the Professional Payer ID grid on our website at www.ibx.com/edi.

All providers

The ID cards for these Blue Cross Blue Shield Medicare Advantage PPO enrollees will contain “MA” in the suitcase logo. These enrollees have been instructed to provide their Blue Cross Blue Shield Medicare Advantage PPO ID card — not their standard Medicare ID card — when presenting to your office/facility for services.

The Centers for Medicare & Medicaid Services (CMS) National Coverage Determinations (NCD) and the Local Coverage Determinations (LCD), as well as Independence Blue Cross (IBC) select Reimbursement Policies, will be applied to claims for a Blue Cross Blue Shield Medicare Advantage PPO plan enrollee by IBC as a Host Plan. Home Plan Medical Policy may still be applied. For CMS-1500 or 837P claims received, the National Correct Coding Initiative edits of CMS will be applied during claims adjudication.

All claims submissions for Blue Cross Blue Shield Medicare Advantage PPO enrollees, to the Host Plan IBC, must be completed in accordance with Personal Choice 65SM PPO guidelines.

ResourcesVisit www.ibx.com/medpolicy for more detailed information regarding NCDs and LCDs or to view a list of the applicable IBC Reimbursement Policy documents, which will be available later this month. Be sure to visit the site often, as it is updated regularly.

If you have any questions about Blue Cross Blue Shield Medicare Advantage PPO, please contact your Network Coordinator.

Note: Behavioral health providers can expect to receive communications regarding this initiative directly from Magellan Behavioral Health, Inc., an independent company; however, all other aspects of this product apply.

October 2010 | Partners in Health UpdateSM 6 www.ibx.com/providers

Billing

Effective January 1, 2011, the inpatient copayment applicability for members of commerical HMO and PPO Benefits Plans for any admission occurring within ten calendar days of the discharge date from any previous admission will be calculated at ten days following the discharge instead of 90 days. The change applies when a member is discharged from an acute-care hospital, rehabilitation hospital, skilled nursing facility, and/or a mental health/substance abuse facility and admitted to one of these facilities within ten days.

The second admission will be treated as part of the first admission to calculate days toward the member’s inpatient copayment-per-admission maximum. This means that IBC will count both hospital stays as one admission for the copayment calculation.

The illustrative example below describes the recalculation process for a member who has a $100 per day copayment, a maximum benefits liability of $500 per inpatient stay, and is readmitted within ten days of the first discharge.

The member is admitted to Hospital A for four days. ●Hospital A will receive a Statement of Remittance (SOR) from IBC showing that the patient’s liability is $400 for this stay. Hospital A bills the member for $400, and the member pays the bill. The member has not met his or her maximum copayment per admission liability of $500.

Within ten days the member is admitted to Hospital B for ●seven days. The hospital will receive an SOR from IBC showing a $500 member copayment liability. Hospital B bills the member for $500, and the member pays the bill.

IBC identifies this member as being admitted within ●ten days, considers the stays at Hospital A and Hospital B as only one admission for member copayment responsibility, and adjusts the claim to recalculate the number of days accumulated toward the member’s inpatient copayment maximum. A corrected SOR is sent to Hospital B indicating that the member is liable for only $100, representing the balance left to satisfy after the first admission.

In this example, the member has already paid $500 to Hospital B. When Hospital B receives the corrected SOR, it has a responsibility to refund the member the $400 difference between the first SOR for $500 and the corrected SOR for $100 representing the $400 (the waived portion of member liability).

Note: The member does not need to be admitted to the same location as the discharge.

If you have any questions regarding this new process, please contact your Network Coordinator.

Change to member copayment applicability for second inpatient admissions within ten days

Effective October 1, 2010, IBC has updated its professional fee schedules and modified its HMO/POS reimbursement methodology for Delaware and Maryland primary care physicians (PCPs).

A letter with additional information was mailed to Delaware and Maryland PCPs last month. Please contact your Network Coordinator with any questions.

New professional fee schedules and revised reimbursement for all Delaware and Maryland PCPs

October 2010 | Partners in Health UpdateSM 7 www.ibx.com/providers

Primary care physicians must select a designated site for all laboratory services for their HMO and POS members. This designated laboratory site is identified by an alpha indicator and can be found on the front of the member’s ID card, as shown on the sample below.

It can also be verified through the NaviNet® web portal or the Provider Automated System. Participating providers should refer HMO and POS members to this designated site for all laboratory services.

With one of the most extensive laboratory networks in Pennsylvania, we are consistently evaluating our current participating provider list. In the unusual circumstance that you require a specific test for which you believe no

participating laboratory can perform, please contact IBC as preapproval/preauthorization is required for use of nonparticipating laboratories. Members who have out-of-network benefits may choose to access a nonparticipating laboratory but will have greater out-of-pocket costs associated with that service.

If IBC determines there is an ongoing and material practice of physicians sending referrals to nonparticipating laboratories, then IBC directly notifies physicians and reminds them of their contractual obligations under the terms of their Agreement. Repeated behavior after initial notification may cause IBC to take any action available under the terms of the Agreement.

We encourage professional providers to set up accounts with designated laboratory sites to accommodate testing needs, improve record-keeping, promote communication between the laboratory and the physician, and facilitate timely receipt of laboratory supplies. For more information regarding designated laboratory sites, please refer to the Provider Manual for Participating Professional Providers in the Specialty Programs and Laboratory Services section under Laboratory Services.

Billing

Laboratory name Lab indicator on ID card Phone numberAbington Memorial Hospital Laboratory A 215-481-2331

Health Network Laboratories N 1-877-402-4221

Hospital of the University of Pennsylvania Laboratory* H 1-800-789-7366

Laboratory Corporation of America L 1-866-297-3210

Mercy Health Laboratory M 610-237-4175

Quest Diagnostics® Q 1-800-825-7320

SMA Medical Laboratories F 215-322-6590

Thomas Jefferson University Laboratory* T 215-955-6545

*Available to specific practices only

PPO members may use any participating laboratory listed above. In addition to these designated laboratories, the following participating specialized laboratory providers also offer specialized pathology testing.

Laboratory name Specialty Phone numberAmeriPath New York, Inc. Dermatopathology only 1-800-553-6621

CBL Path Pathology, oncology, genetic testing 1-877-225-7284

DIANON Systems, Inc. Pathology, oncology, genetic testing 1-800-328-2666

Genomic Health Oncotype DX® only 1-866-662-6897

Genzyme Genetics Reproductive/Genetic/Oncology testing only 1-800-848-4436

Institute for Dermatopathology Dermatopathology only 610-260-0555

Litholink Kidney stone prevention 1-800-338-4333

Monogram Biosciences Trofile co-receptor tropism assay only 650-635-1100

Myriad Genetics BRAC analysis, COLARIS® and COLARIS AP® only 201-791-3600

Penn Cutaneous Pathology Dermatopathology only 1-866-337-6522

Laboratory services reminder

Lab indicator

DR JANE A SAMPLE MDJOHN Q.SAMPLE

LAB Q

Rx BIN PLAN123456Rx PCN 12345678 PCP

SPECER

$5$10$25

HMO

215-555-1212

October 2010 | Partners in Health UpdateSM 8 www.ibx.com/providers

Billing

IBC has identified an increase in claims for follow-up care provided in an emergency room (ER) setting. Generally, follow-up care after an ER visit is considered routine care. Members should be referred by the ER to an appropriate primary or specialty care physician for any routine follow-up care, such as the removal of sutures and wound dressing. Directing follow-up care back to the ER setting results in higher out-of-pocket costs for IBC members.

The following are examples of routine follow-up care that have been erroneously provided in an ER setting:

Patient returns to have a prescription extended that was written in the ER. ●Patient returns to the ER for reapplication of bandages, splints, or wraps. ●Patient, who had a laceration repaired with sutures, returns to have the sutures removed. ●

Routine (non-emergent) follow-up care provided in the ER setting by a participating provider is not eligible for a separate ER visit payment. Payment for follow-up care provided in the ER shall be considered included in the payment to the participating provider for the initial ER visit.

Additional information on ER services can be found on the NaviNet® web portal in the current editions of the Hospital Manual for Participating Hospitals, Ancillary Facilities, and Ancillary Providers and Provider Manual for Participating Professional Providers.

Emergency room follow-up care reminder

IBC is changing primary care physician (PCP) capitation rates due to a new set of cost-sharing rules mandated by the federal health care reform act known as the Patient Protection and Affordable Care Act of 2010 (Act). As required by the Act beginning October 1, 2010, there will be no member cost-sharing (i.e., $0 copayment) for certain preventive services provided to members. We will publish Claim Payment Policy #00.06.02: Preventive Care Services, which includes the list of applicable preventive codes. This policy will be available on the NaviNet® web portal or at www.ibx.com/medpolicy.

As it is expected to take several years for this change to be phased in across IBC health benefits plans based on the terms of the member’s Benefits Program Agreement, it continues to be important that you always check NaviNet and ID cards for member benefits information.

The following changes are necessary as benefits modifications will be rolled out to existing employer groups upon their renewal:

Preventive care $0 copayment capitation rates. ● Your capitation rates will increase to account for this benefits change for members with a new $0 copayment benefits plan for preventive care services. This benefit and rate of capitation payment change is effective October 1, 2010, for certain commercial HMO and POS benefits plans and January 1, 2011, for all Medicare Advantage HMO plans. The PCP capitation rates have

been increased to account for the actuarial value of preventive care copayments currently collected under these benefits plans.

Other capitation rates. ● For commercial and Medicare Advantage HMO members whose benefits for preventive services are not changing, the capitation rates currently in effect will continue to be paid.

To check a member’s benefits on NaviNet, select Member Eligibility and Benefits Inquiry from the Plan Transactions menu. If you are not NaviNet-enabled, go to www.navinet.net and select Sign up from the top right. You can also register for NaviNet by calling the IBC eBusiness Provider Hotline at 215-640-7410.

Revised capitation rates and $0 copayment for certain preventive services

October 2010 | Partners in Health UpdateSM 9 www.ibx.com/providers

Billing

Beginning mid-October, providers will see an enhancement to prompt pay interest on adjusted claims. Interest payments on adjusted claims will be processed in the same manner as original claims.

Currently, original claims interest generates to the provider the same time the claim payment is made. Interest on adjusted claims is paid after the adjustment payment date.

With the interest payment enhancement, interest will be paid along with the adjusted claim payment. Also, when a claim is retracted, any interest paid will be retracted as well.

As a result, the Statement of Remittance (SOR) will display interest paid on original claims, adjusted claims, and retracted interest. Both the retracted claim amount and the retracted interest will appear on the AR Detail page. Please view the SORs below for an example of the changes.

Please contact your Network Coordinator with any questions.

Enhancements to the interest payment process begins mid-October 2010

October 2010 | Partners in Health UpdateSM 10 www.ibx.com/providers

mediCal

As announced on our Medical Policy website, IBC has established a new policy on private duty nursing (PDN) that will become effective October 15, 2010. Medical Policy #02.01.02: Private Duty Nursing is intended to provide direction on the medical necessity requirements and explain what distinguishes PDN from a skilled nursing visit. PDN is considered medically necessary based on the medically appropriate criteria outlined in this policy.

PDN is defined as medically appropriate, complex skilled nursing care in the individual’s private residence by a registered nurse or a licensed practical (vocational) nurse. The purpose of PDN is to provide continuous monitoring and observation of an individual who requires frequent skilled nursing care on an hourly basis. In addition, PDN may assist in the transition of care from a more acute setting to home and teaches competent caregivers the assumption of this care when the condition of the member is stabilized.

To read this policy in its entirety, visit www.ibx.com/medpolicy and enter the policy number in the search field.

Our policy on private duty nursing

Policy notifications posted as of September 20, 2010All policies are posted prior to their effective date. Below is a listing of the policy notifications that we have posted to our website as of September 20, 2010.

Policy effective date

Notification titleNotification issue date

October 1, 2010 06.02.15b Direct Measurement of Intermediate-Density Lipoproteins September 1, 2010

October 13, 2010 08.00.55c Omalizumab (Xolair®) September 13, 2010

October 15, 2010 11.14.19e Artificial Intervertebral Disc Insertion September 15, 2010

October 15, 2010 00.01.44b Never Events and Preventable Adverse Events September 15, 2010

October 15, 201007.07.03f Photodynamic Therapy (PDT) Using Levulan® Kerastick®

(Aminolevulinic Acid HCl [ALA]) or Metvixia® (Methyl Aminolevulinate)

September 15, 2010

October 15, 2010 02.01.02 Private Duty Nursing September 15, 2010

October 15, 2010 05.00.55e Wheelchair Cushions and Seating September 15, 2010

December 15, 2010 08.00.94 Denosumab (Prolia™) September 16, 2010

To view these notifications, as well as the policies in full, go to www.ibx.com/medpolicy, select Accept and Go to Medical Policies, and then select Policy Notifications. Be sure to check back often, as the site is updated frequently.

October 2010 | Partners in Health UpdateSM 11 www.ibx.com/providers

mediCal

Effective January 1, 2011, we will revise our coverage position on Medical Policy #11.14.13: Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions to apply to all members.

Also, as a result of the IBC medical policy review process, the policy has been updated to state that ESWT that uses high- or low-dose protocol or radial ESWT for the treatment of any musculoskeletal conditions is considered experimental/investigational and, therefore, not covered because the safety and/or efficacy of this service cannot be established by review of the available published peer-reviewed literature. IBC will not provide payment or reimbursement on any claims for ESWT services performed for these conditions on or after January 1, 2011.

ESWT is a noninvasive method that delivers shock waves to a specific site within the body, which creates a transient pressure disturbance that affects solid structures, breaking them into smaller fragments that allow

passage and/or removal of stones. ESWT has been studied in the treatment of various musculoskeletal conditions, including plantar fasciitis, tennis or golfer’s elbow, rotator cuff injuries, bursitis, and other overuse injuries. All these chronic conditions consist of a complex syndrome of tendonitis, inflammation, adhesions, and the buildup of calciferous deposits in the affected area.

These chronic musculoskeletal conditions have traditionally been treated with rest, ice, massage, anti-inflammatory medications, ultrasound, acupuncture, physical therapy, and surgery. The main outcomes evaluated in the treatment of chronic musculoskeletal conditions are improvements in pain and function (i.e., activity). There is insufficient and inconsistent evidence to conclude that ESWT improves net health outcomes for musculoskeletal conditions.

The policy notification for this change can be viewed on our website at www.ibx.com/medpolicy by typing the policy number into the search field.

Coverage position change on ESWT for musculoskeletal conditions

This is a reminder of the criteria required for the use of modifier -25 when reporting Evaluation & Management (E&M) services along with chemotherapy administration and dialysis codes. On the same day that a chemotherapy/dialysis administration service is performed, an individual’s condition or symptoms may require a significant, separately identifiable E&M service above and beyond the other service provided. In such instances, it is appropriate to append modifier -25 to the E&M code. Modifier -25 must be appended to the E&M code for reimbursement consideration.

For additional information on the appropriate reporting of modifier -25 with an E&M code, see Medical Policy #03.00.06: Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service. This policy is available on our website at www.ibx.com/medpolicy.

Use of modifier -25 when reporting E&M services with chemotherapy administration and dialysis codes

October 2010 | Partners in Health UpdateSM 12 www.ibx.com/providers

mediCal

IBC requires that certain drugs receive precertification before coverage is available for our members. Precertification ensures that members meet the medical necessity criteria listed in our policies. Effective January 1, 2011, there will be two new components for precertification:

For ● all drugs covered under the medical benefit that require precertification, providers will be required to report member demographics, such as height and weight.

For the following eight drugs, adherence to Dosing and Frequency Guidelines will be reviewed during precertification: ●cetuximab (Erbitux– ®)trastuzumab (Herceptin– ®)onabotulinumtoxinA (Botox– ®)bevacizumab (Avastin– ®)rituximab (Rituxan– ®)oxaliplatin (Eloxatin– ®)intravenous immune globulin (IVIG)– infliximab (Remicade– ®)

The Dosing and Frequency Guidelines will be included in the medical policies for these eight drugs. To view the policy notifications for these eight policies, go to www.ibx.com/medpolicy, select Accept and Go to Medical Policy Online, and then click on the Policy Notifications box. You can also view policy notifications using the NaviNet® web portal by selecting Reference Materials and Reports from the Plan Transactions menu and then Medical Policy.

The Dosing and Frequency Guidelines help IBC verify that our members’ drug regimens are in accordance with national prescribing standards. These guidelines are based on current U.S. Food and Drug Administration approval, drug compendia (e.g., American Hospital Formulary Service Drug Information®, Micromedex®), industry-standard dosing templates, drug manufacturers’ guidelines, published peer-reviewed literature, and pharmacy and medical consultant review. Requests for coverage outside these guidelines require documentation (i.e., published peer-reviewed literature) to support the request.

Please contact your Network Coordinator if you have any questions about these new requirements.

Two new components for precertification

It is our policy that all utilization review decisions are based on the appropriateness of health care services and supplies, in accordance with the benefits available under the member’s health plan and our definition of medical necessity. Only physicians may make denials of coverage of health care services and supplies based on lack of medical necessity.

The nurses, medical directors, other professional providers, and independent medical consultants who perform utilization review services for us are not compensated or given incentives based on their coverage decisions. Medical directors and nurses are salaried employees, and contracted external physicians and other professional consultants are compensated on a per-case reviewed basis, regardless of the coverage determination. We do not reward or provide financial incentives to individuals performing utilization review services for issuing denials of coverage. There are no financial incentives for such individuals that would encourage utilization review decisions that result in underutilization.

Policy reminder regarding utilization review decisions

October 2010 | Partners in Health UpdateSM 13 www.ibx.com/providers

As you may be aware, Keystone Health Plan East Point-of-Service (KPOS) members must choose a primary care physician (PCP); however, unlike HMO members, they have the option of seeing a specialist who is either in- or out-of-network. When KPOS members seek specialty services, they must have a referral from their PCP to receive the maximum benefits level. However, they also have the option to self-refer and receive specialty services without a referral — they are then responsible for any additional out-of-pocket expenses. This self-referred benefit applies to both in-network and out-of-network providers.

KPOS members may need preauthorization for some specialty services. When you request preauthorization through the NaviNet® web portal for these members, you will be asked, “Has the member been referred by the PCP for treatment?” It is very important to answer “Yes” if your office has a referral on file for the member to ensure that the highest level of benefits is covered for the member. Please be sure to check the member’s chart for a referral, or verify that an electronic referral is “on file” through NaviNet by selecting Encounters and Referrals from the Plan Transactions menu and then Referral Inquiry.

If you incorrectly answer “No” and the member has a referral on file, the system will automatically default to the self-referred benefits level, and the member will be subject to erroneous out-of-pocket expenses. In addition, if the system defaults to the self-referred benefits level, you may receive the following message due to the differences in preauthorization requirements: “This member’s benefits program does not require pre-authorization for the procedure(s) requested based upon the information provided.” Claims will be denied for lack of preauthorization.

Note: Members seeking routine care from a participating OB/GYN provider are not required to have a PCP referral under the Direct Access program rules. For correct claims payment, please answer the question mentioned above with a “Yes,” meaning that the member is referred for treatment. This will ensure that the member’s benefits are managed correctly.

If you have any questions about requesting preauthorization for KPOS members, please contact your Network Coordinator.

How referrals affect KPOS members’ coinsurance for services requiring preauthorization

navinet®

October 2010 | Partners in Health UpdateSM 14 www.ibx.com/providers

navinet®

As previously communicated, all NaviNet-enabled provider sites are now required to submit their initial authorization requests through NaviNet.

Please note that this is not a change in medical policy. Providers should continue to submit only those requests for services they provide to our members. Primary care physicians are not required to submit authorization requests for services provided by another specialist or facility.

The following authorization requests must be requested through NaviNet:

medical/surgical procedures ●cardiac rehab ●chemotherapy/infusion ●durable medical equipment ●emergency hospital admission notification ●home health ●

dietitian –home health aide –occupational therapy –physical therapy –skilled nursing –social work –speech therapy –

home infusion ●outpatient speech therapy ●pulmonary rehab ●sleep studies ●

Please note that providers should continue to submit requests to American Imaging Management (AIM) for those radiology services requiring precertification.

Authorization requirements for non-enabled sitesAll provider groups will be required to have all sites enabled by December 31, 2010. To register for NaviNet, go to www.navinet.net and select Sign up from the top right. Register no later than November 1, 2010, to obtain access by December 31, 2010.

Once provider sites become enabled, they will be required to submit their initial authorization requests through NaviNet.

If your office is currently NaviNet-enabled and would like training on how to submit authorizations, please call the eBusiness Provider Hotline at 215-640-7410.

Note: This information does not apply to providers contracted with Magellan Behavioral Health, Inc., an independent company. Magellan-contracted providers should contact their Magellan Network Coordinator at 1-800-866-4108 for authorizations.

Clarification: Authorization submission requirements through NaviNet

October 2010 | Partners in Health UpdateSM 15 www.ibx.com/providers

PharmaCy

This is a reminder about the Synagis® (palivizumab) distribution program for the 2010-2011 respiratory syncytial virus (RSV) season, which is November through April in the United States. According to the Centers for Disease Control and Prevention, RSV is the most common cause of bronchiolitis and pneumonia among children younger than 1.

During the RSV season, we will approve the monthly administration of Synagis® (palivizumab) for at-risk children younger than 2. Synagis® (palivizumab) is a humanized monoclonal antibody that provides passive immunity against RSV. It is intended to decrease the morbidity and mortality associated with RSV lower respiratory tract disease in at-risk children, which includes children with one of the following conditions and specific risk factors:

chronic lung disease of prematurity (CLD, formerly ●called bronchopulmonary dysplasia);

history of preterm birth (< 35 weeks 0 days gestation); ●congenital heart disease; ●severe neuromuscular disease; ●congenital abnormalities of the airway. ●

Recommendations for premature infantsSpecific recommendations have been made to reduce the risk of RSV hospitalization for infants who are born at 32 through less than 35 weeks gestation (defined as 32 weeks 0 days through 34 weeks 6 days). Synagis® (palivizumab) prophylaxis should be limited to these infants who are at greatest risk of hospitalization due to RSV. This includes at-risk infants who are younger than 3 months and 0 days (less than 90 days) at the start of the RSV season, as well as those who are born during the RSV season and are likely to have an increased risk of exposure to RSV.

Epidemiologic data suggests that RSV infection is more likely to occur and lead to hospitalization for infants in this gestational age group when at least one of the following risk factors is present:

The infant attends child care (defined as a home or ●facility where care is also provided for any number of infants or young toddlers in the same facility).

The infant has a sibling younger than 5. ●

Prophylaxis may be considered for infants born at 32 through less than 35 weeks gestation whose chronological age is less than 3 months before the onset or during RSV season and for whom at least one of the above factors is present.

Infants in this gestational age category should receive prophylaxis only until they reach 3 months of age. In addition, these infants should receive a maximum of three monthly doses; many will receive only one or two doses until they reach 3 months of age.

Once an infant has passed 3 months of age (older than 90 days), the risk of hospitalization attributable to RSV lower respiratory tract disease is reduced. Administration of Synagis® (palivizumab) is not recommended after 3 months of age. This criteria for premature infants is based on updated guidelines published in the 2009 American Academy of Pediatrics (AAP) Red Book® and is a change from the 2008-2009 RSV season recommendations for infants.

How to obtain Synagis® for use in your officeSynagis® (palivizumab) is a medical benefit managed by the FutureScripts® Direct Ship Specialty Pharmacy Program and facilitated by ACRO Pharmaceutical Services, an independent company. ACRO Pharmaceutical Services will provide Synagis® (palivizumab) exclusively for IBC during the 2010-2011 RSV season, and it is mandatory that all participating providers obtain Synagis® (palivizumab) through the FutureScripts Direct Ship Specialty Pharmacy Program. ACRO Pharmaceutical Services will ship the agent directly to your office.

Annual Synagis® (palivizumab) distribution program

continued on page 16

October 2010 | Partners in Health UpdateSM 16 www.ibx.com/providers

PharmaCy

Quality management

We want to recognize practices that have demonstrated a dedication to high-quality patient care by achieving the highest Practice Quality Assessment Score (PQAS) rank in 2010. PQAS is a comprehensive ranking system of quality measures and member satisfaction for primary care offices with 75 or more HMO members. We congratulate the practices listed on the following page for achieving excellence in aggregate in the following areas of preventive care:

childhood immunization; ● cancer prevention in the areas of cervical, colon and rectal, and breast cancer screening; ● diabetes care (HbA1c testing, LDL testing, eye exam rates, and nephropathy screening); ●heart care (LDL testing after a heart attack); ● asthma care (use of anti-inflammatory medications for people with chronic persistent asthma); ●well-child visits. ●

Congratulations again for demonstrating excellence in quality and member satisfaction.

Quality ranking for primary care physician offices

Guidelines for ordering Synagis® (palivizumab)

The following guidelines apply when ordering Synagis® (palivizumab):

Synagis ● ® (palivizumab) will generally be approved for office administration only, unless a patient is receiving home nursing services for a separate indication.

The ● RSV Enrollment Form must include sufficient clinical information to meet our Synagis® (palivizumab) medical policy criteria, which is based on recommendations from the AAP.

Tobacco smoke will not be accepted as an ●environmental pollutant. This guideline is based on the indication from the AAP Committee on Infectious Disease that, while at-risk infants should never be exposed to tobacco smoke, passive household exposure to tobacco smoke has not been associated with an increased risk of RSV hospitalization on a consistent basis.1

Fee-for-service providers will be reimbursed for ●the Evaluation & Management procedure codes that correspond to the patient’s office visit. Since FutureScripts will pay ACRO Pharmaceutical Services directly, you will neither pay for doses ordered through the FutureScripts Direct Ship Specialty Pharmacy Program nor receive reimbursement for the actual pharmaceutical.

Upon approval of your request, Synagis ● ® (palivizumab) will be shipped to your office monthly during RSV season. Overnight shipping for the 2010-2011 RSV season begins on Wednesday, October 27, 2010, and ends on Thursday, March 31, 2011. Up to five doses (one shipment every 30 days) will be shipped per patient.

If you have questions about the Synagis® (palivizumab) distribution program, please contact Customer Service at 1-800-ASK-BLUE.

Note: Synagis® (palivizumab) is not effective in the treatment of RSV disease, and it is not approved for this indication.

This is not a statement of benefits. Benefits may vary according to state requirements, product line (HMO, PPO, etc.), and/or employer groups. Member coverage can be verified by calling Customer Service at 1-800-ASK-BLUE.

1American Academy of Pediatrics, 2006 Red Book, pp 563-565.

Annual Synagis® (palivizumab) distribution program (continued)

continued on page 17

October 2010 | Partners in Health UpdateSM 17 www.ibx.com/providers

Quality ranking for primary care physician offices (continued)

Abington Bucks Internal Medicine ●Abington Cedarbrook Internal Medicine ● Abington General Internal Medicine ●Isaac Abir, M.D. ●Samir R. Akruk, M.D. ● Ambler Pediatrics, PC ●Andorra Pediatrics ●ARIA Physician Services — Palat ● ARIA Physician Services — Oxford ●Internal Medicine

Associated Family Practice Professionals ●(Trevose)

Associated Family Practice Professionals ●(Philadelphia)

George Avetian Family Practice ●Wilfreta G. Baugh, M.D. ●Vicky P. Berberian, M.D. ●Bishnu Charan Borah, M.D., PC ●Murray Brand Associates ●Bridgetown Family Practice ●Broderman Internal Medicine Associates ●Bucks County Family Practice, PC ●Bucks County Pediatrics ●Bucks Family Medical Associates ●Buxmont Medical Associates ●Care Network — Highpoint ●Care Network — Indian Valley ●Care Network — Springfield ●Lee A. Celio, M.D. ●Center City Pediatrics, LLC ● Cevallos and Moise Pediatric Associates, PC ●William T. Chain, Jr., M.D. ●Cheltenham Internal Medicine ●Chester County Internal Medicine ● Marion C. Childs, M.D., Pottstown ●Medical Associates

Ronald A. Codario, M.D., PC ● Colonial Family Practice, Gateway ●Medical Associates

Cowpath Pediatrics, LLC ●M. Cramer and A. Cramer, M.D.s ● Delaware Valley Medical and Wellness Center ●Delphi Family Health Center ●Usha B. Desai, M.D., PC ●Marcelino Desantos, M.D., PC ●Thomas C. Detweiler, M.D. ●Doylestown Family Medicine, PC ●Einstein Community Health ●Elefant Galante, PC ●Elliott Internal Medicine ●Ellis and Sitkoff, PC ● David E. Epstein, M.D. — Main Line ●Family Medicine

Family Practice Associates of King of ●Prussia, PC

Richard M. Finkelstein, M.D. ● Harry A. Frankel, M.D. — Jefferson ●Medical Care, PC

Matthew Frankel, M.D. ●Joel Goldberg, D.O. ●Gordon Klinow Pediatric Associates ●Great Valley Medical Associates, PC ● G. S. Peter Gross, D.O., PC ●(732 S. 8th Street)

G. S. Peter Gross, D.O., PC ●(2240 S. 3rd Street, Whitman Medical Center)

Leonard Haltrecht, D.O., PC ● Health Access Network — Glenn R. ●Ortley, D.O.

Susan D. Hoffman, M.D. ●Horsham Pediatric Association, PC ●Yehchiu Hsieh, M.D. ●Arlene P. Imber, D.O. ●Jefferson Medical Care — Chinatown ●Ronda Karp, D.O. ●Wonhee Kim, M.D. ●Min-Hsiung Ko, M.D. ●Marc M. Kress, M.D. and Associates ●Kressly Pediatrics, PC ●E. Gary Lamsback, M.D. ●Lawndale Medical Associates ●Luxembourg Medical Associates ● Lehigh Valley Physician Group — ABC ●Family Pediatrics

Anna C. Lysiak, M.D. ●Joseph F. Mambu, M.D., PC ●Marder Medical Associates, PC ●Margiotti and Kroll Pediatrics, PC — Trevose ● Raymond S. McLaughlin, M.D. — Longwood ●Corporate Center

Meadowbrook Pediatrics, PC ●Medical Group at Marple Commons ●Mercy Medical Associates at Springfield ●John E. Moskaitis, M.D. ● Myers, Squire & Limpert Family Practice, ●Gateway Medical Associates

Newtown Medical Group at Victoria ●Commons

North Willow Grove Pediatrics, PC ● Northeast Internal Medicine, ARIA ●Physician Service

Northwest Internal Medicine, PC ●P.I.M. Associates, PC — Jenkintown ● P.I.M. Associates, PC — Philadelphia ●Paoli Pediatrics ●Mukesh A. Patel, M.D. ●

Peace Valley Internal Medicine, PC ● Lawrence R. Peck, D.O., Morrisville ●Yardley Family Practice

Pediatric Associates of Paoli ●Pediatric Associates of Plymouth ●Pediatric Care Group, PC ● Penncare Medicine at Radnor — Penncare ●Adolescent Young Adult Associates

Pennsburg Family Practice, Family Health ●Care Center

Personal Physician Services, PC ●Stanley F. Peters, M.D. ●David M. Petro, D.O. ●Joseph W. Price, M.D. ●Prime Health Network ●Quakertown Family Medical Center, PC ●Vincent S. Reina, D.O. ●Keith S. Rothman, M.D. ●John L. Sabatini, D.O. ● Susan Sandler, M.D. — Main Line Family ●Medicine

Herbert Secouler, D.O. ●Jay and Vijaya Shah, M.D. ●Steven Sklar, D.O., PC ●Arthur K. Smith, M.D. ●J. Andrew Solis, M.D., PC ●Southampton Pediatric Associates, PC ●Edward P. Spiegel, M.D. ●St. Luke’s Quakertown Family Practice ●Stonybrook Medical Center ● Stowe Family Practice — Pottstown ●Medical Specialists

Temple Physicians, Inc. — Baiocchi and ●Rosenberg

Temple Physicians, Inc. — Jenkintown ●Medical Group

Temple Physicians, Inc. — Pediatrics ● Temple Physicians, Inc. — Wyndmark ●Medical Associates

Malcolm S. Thaler, M.D. ● University of Penn Health System — ●Penncare — Chestnut Hill

University of Penn Health System — ●Penncare — West Chester

M. Louis Vandebeek, M.D. ●Westtown Valley Medical Associates ● Whiteland Medical Associates for ●Progressive Health

Gregory D. Williams, M.D. ●Willow Grove Internal Medicine ●Christine Zabel, D.O. ●Alice J. Zal, D.O. — Family Medical Care ●Zweiback Medical Associates ●

Congratulations to the PCP offices listed below for demonstrating excellence by achieving the highest PQAS rank in 2010 based on 2009 data. They are listed alphabetically by group name or provider last name.

Quality ManageMent

October 2010 | Partners in Health UpdateSM 18 www.ibx.com/providers

health and Wellness

We encourage our members to get vaccinated against the seasonal flu and ask that you advise your patients to receive a vaccination as soon as possible. This year, the seasonal flu vaccine has been combined with the H1N1 flu vaccine so only one vaccination is required for adults. Children, however, may need one or two flu shots, depending on their age and previous history of flu vaccination.

The recommendations for the 2010-2011 flu season from the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices include flu vaccination for all people 6 months and older, especially pregnant women.

For more information about this year’s flu vaccine, visit the CDC’s flu website at www.cdc.gov/flu.

Seasonal flu vaccine recommendations

The ConnectionsSM Health Management Program is pleased to announce that the annual Connections Program Provider Satisfaction Survey is coming soon.

We’ve updated the survey to ask your opinion of the program’s impact on patients’ use of services, including emergency department services, inpatient hospital services, tests and procedures, and physician visits. The annual survey allows you to tell us what you think of Connections, which may help us improve program services in the future.

Other questions will assess:

your overall satisfaction with access to and interactions with the Connections staff; ●how Connections affects your patients’ health status relative to their target condition; ●how Connections affects your patients’ health status and treatment plan adherence; ●your satisfaction with the frequency of communication from Connections. ●

Take the survey online by visiting http://survey5.opinionresearch.com/surveys/J5200400/J5200400.asp. If you have any problems with the online survey or need a paper copy, please contact a Connections Provider Specialist at 1-866-866-4694.

We encourage you to take the Connections survey today, and we thank you in advance for your participation.

ConnectionsSM wants to hear from you

Health Coaches also provide decision support for numerous health-related issues, including back pain, depression, weight loss surgery, breast or prostate cancer, and medication persistence.

ConnectionsSM Health Management Programs: Supporting your patients, our members

Call the Provider Support Line at 1-866-866-4694 to refer a member to a Health Coach if the member has any of the following conditions:

Connections Health Management Program information is available by visiting www.ibx.com/providerconnections.

n asthma

n diabetes

n chronic obstructive pulmonary disease (COPD)

n chronic pain

n �coronary heart disease (CHD)

n migraine

n heart failure

n hypertension

n gastroesophageal reflux disease (GERD)

n peptic ulcer disease (PUD)

I m p o r t a n t r e s o u r c e s

* Outside 215 area code

Anti-Fraud and Corporate Compliance Hotline 1-866-282-2707

www.ibx.com/antifraud

Care Management and Coordination Case Management

215-567-35701-800-313-8628*

Baby BluePrints® 215-241-21981-800-598-BABY (2229)*

ConnectionsSM Health Management Programs ConnectionsSM Health Management Program Provider Support Line 1-866-866-4694

ConnectionsSM Complex Care Management Program 1-800-313-8628

Credentialing Credentialing Hotline

215-988-6534www.ibx.com/credentials

Credentialing Violation Hotline 215-988-1413

Customer Service/Provider Services Provider Automated System (eligibility/claims status/referrals) Connections Health Management Programs Precertification/maternity requests — Imaging services (CT, MRI/MRA, PET, and nuclear cardiology) — Authorizations

1-800-ASK-BLUE

Provider Services user guide www.ibx.com/providerautomatedsystem

eBusiness Help Desk 215-241-2305

FutureScripts®

Prescription drug authorization Toll-free fax

1-888-678-70121-888-671-5285

Direct Ship Specialty Pharmacy Program Fax

1-888-678-7012215-761-9165

Blood Glucose Meter Hotline 1-888-678-7012

Pharmacy website (formulary updates, prior authorization) www.ibx.com/rx

FutureScripts® Secure Medicare Part D 1-888-678-7015

Formulary updates www.site65.com

Medical Policy website www.ibx.com/medpolicy

NaviNet® portal registration www.navinet.net

Provider Supply Line 1-800-858-4728

www.ibx.com/providersupplyline

Visit our website: www.ibx.com/providercommunications