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DPAP 106

Code of Ethical Business Conduct


Provider Administrative Policy

Section
Information
Policy Date
January 2012
Status/Date
New/January 2012
Provider Type(s)
All Providers  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Blue Cross of Idaho works diligently on behalf of our members to develop contracting relationships with Idaho dental providers and Blue Cross Blue Shield dental affiliates (national Dental Grid).

 


Policy

Code of Ethical Business Conduct

Blue Cross of Idaho (Company) prepared the Code of Ethical Business Conduct to provide our company's Board of Directors (directors), corporate officers and employees, Associated Entities (providers, vendors, agents, brokers, contractors, and subcontractors, including first tier, downstream and related entities), the general public, and other entities with whom we do business, with a formal statement of the Company's commitment to the standards and rules of ethical business.

APPLICABILITY
Blue Cross of Idaho expects our directors, corporate officers, employees and Associated Entities to act in an ethical manner and comply with applicable laws and regulations. We encourage associated entities to adopt and follow a Code of Conduct particular to their own organization that reflects a commitment to detecting, preventing and correcting  fraud, waste and abuse in the administration and delivery of Blue Cross of Idaho products, including Medicare Advantage (Part C) and Medicare Advantage Prescription Drug Plan (Part D) benefits.

PRIMARY PRINCIPLE OF THE CODE OF ETHICAL BUSINESS CONDUCT

Primary Principle Business Ethics
Blue Cross of Idaho directors, corporate officers, employees and Associated Entities will accurately and honestly represent the Company and adhere to the highest ethical standards at all times. They should deal fairly without customers, suppliers, competitors and employees.

SIX ACCOMPANYING PRINCIPLES

  • Principle 1 - Legal Compliance
    Company directors, corporate officers, agents and Associated Entities agree to obey all applicable laws.
  • Principle 2 - Conflicts of Interest
    Company directors, corporate officers, employees, agents and Associated Entities agree to obey all applicable laws.
  • Principle 3 - Business Relationships
    Business dealings with vendors, contractors and other third parties must be transacted free from offers or solicitation of gifts and favors or other improper inducements that would affect the company's business in any way.
  • Principle 4 - Protection of Assets
    Company directors, corporate officers, and employees should protect the company's assets and ensure efficient use for legitimate purposes only. Associate entities are responsible for protecting and efficiently using Blue Cross of Idaho assets when granted custody or , access to, or permission to use Blue Cross of Idaho's assets.
  • Principle 5 - Confidentiality
    Company directors, corporate officers, employees and Associated Entities are required to understand that certain information is confidential and requires prior approval before release.
  • Principle 6 - Government Investigations
    We will cooperate with all government investigations and reasonable requests for information and will treat government investigations as serious matters.

Reporting Violations
The Company will make every effort to maintain the confidentiality and protect the identity of anyone who reports a suspected violation of this code. Directors, corporate officers, employees and Associated Entities shall report their good faith belief of violations of the compliance program or applicable laws in one or more of the following ways:

  • Verbally or in writing to a supervisor or manager
  • By calling the Corporate Compliance Officer
  • By calling any member of the Compliance Committee
  • By calling the Corporate Compliance Hotline at 888-258-3543, Ext. 7424
  • By writing to the Corporate Compliance Officer

Blue Cross of Idaho
Attn:  Corporate Compliance Officer
PO Box 7408
Boise, ID 83707


Policy History

Date Action Reason