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Oregon state health insurance For Physicians, Other Health Care Professionals and Facilities
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Administrative Manual
Section
Change
Revision Date
Introduction (PDF) Updated newsletter and confidentiality information.
11/2009
Who to Contact Information moved to Contact Us and other sections of our Web Site.
11/2009
Credentialing (PDF)  
11/2008
Identifying Members (PDF)

Added updated member card backs for Regence Innova®, Engage®, ActivateSM and Regence HSA Healthplan 2.0SM, and Regence MedAdvantageTM member card samples.
5/2009
Filing Claims (PDF) Minor text changes and updated UB-04 section.
11/2009
Payment (PDF) Minor text changes and updated Innova®, Engage®, ActivateSM, HSA Healthplan 2.0SM and BlueCard claim voucher samples.
11/2009
Appeals (PDF)

Added Member Rights and Responsibilities.
2/2009
Fraud and Abuse (PDF) Expanded section to include topics related to preventing fraud, External Audit, Federal False Claims Act and member card fraud
11/2009
Medical and Reimbursement Policies (PDF) Updated medical and reimbursement policy review processes.
5/2009
Care Management (PDF)  
5/2008
Quality Program (PDF) Added Radiology Quality Initiative language.
5/2009
Behavioral Health (PDF)  
8/2007
Provider Center
(formerly known as Regence Online Services for Providers)

Updated references to the name of the tool. Revision date:

9/2009
RegenceRx® Provider Basics (PDF)  
5/2008
BlueCard® Program (PDF)  
5/2008
Product Overview (PDF) Added information regarding HSA Healthplan 2.0SM.
2/2009
Federal Employee Program (PDF) New section.
2/2009

Medicare Advantage Plans (PDF)
(Effective through 12/31/2009)

Medicare Advantage Plans (PDF)
(Effective 1/1/2010)

 

 

Added 2010 benefit summaries, new member card samples and changed appeal language.

 

 

1/2010
Self-Managed and Consumer Directed Products

Updated deductible options for Innova and Engage and added a new complementary care benefit maximum for Innova, Engage, and Activate.
8/2009
Glossary (PDF) Added definitions related to Self-Managed and Consumer Directed products.
2/2009

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