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Description
The Regence BlueCross BlueShield of Oregon® Reimbursement Policy Manual documents Regence BlueCross BlueShield of Oregon and Regence HMO Oregon® (collectively Regence) payment methodology for medical and surgical services. THIS REIMBURSEMENT POLICY DOES NOT APPLY TO ANY OTHER COMPANY.

Use
Reimbursement Policy is used by Regence to provide consistent and predictable claims payment.

Conflict with Other Documents
Reimbursement Policy facilitates the systematic application of Regence subscriber contracts, provider contracts, and medical policies. These documents will govern in the event of a conflict with the Reimbursement Policy.

Restrictions and Limitations

• Reimbursement Policy DOES NOT determine the schedule of benefits. Rather, Reimbursement Policy supports the schedule of benefits by establishing payment rules, coding hierarchy and related processing systems' edits.
• Reimbursement Policy is interpreted and applied in the sole discretion of the Regence.
• Reimbursement Policy DOES NOT constitute medical advice and DOES NOT guarantee any results or outcomes. If you are a member, you should discuss any related health care questions with your physician or other health care provider.
• Reimbursement Policy is the property of Regence and you are strictly prohibited from using it for any commercial use whatsoever. Commercial use does not include use of the Reimbursement Policy related to benefit payment for health care services received by a Regence member.
• CPT codes and descriptions are the property of the American Medical Association with all rights reserved. You are strictly prohibited from using CPT codes for any unauthorized use whatsoever.
• Every effort is made to update the Reimbursement Policy in a timely manner. However, there is no obligation to update this site and the Reimbursement Policy displayed may be out of date.

Continue to the Reimbursement Policy Manual