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MA PAP222

Direct Correspondence with Medicare Advantage Plan Member


Provider Administrative Policy

Section
Provider Information
Policy Date
May 2008
Status/Date
Revised/January 2012

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.

Policy

Direct Correspondence with Medicare Advantage Plan Member

The Centers for Medicare and Medicaid Services (CMS) has specific guidelines for written communication with current and prospective Medicare Advantage plan participants. In many cases, they require the use of CMS generated model language. These guidelines apply not only to Blue Cross of Idaho but also to providers who send written communication to their patients referencing Blue Cross of Idaho and any of our Medicare Advantage plans.

CMS considers any provider materials that mention Blue Cross of Idaho or any of our Medicare Advantage plans as marketing material. Therefore, these items must adhere to the guidelines set forth in Chapter 3 of the Medicare Advantage Manual, Medicare Marketing Guidelines. These materials also require Blue Cross of Idaho and CMS approval prior to distribution.

You can send your materials to our Provider Relations department. We will review your material and submit to CMS as necessary, then notify you with approval or denial.

Send provider-generated materials referencing True Blue HMO, Secure Blue PPO or Blue Cross of Idaho for review to:

  • Blue Cross of Idaho
    Attn: Provider Relations
    PO Box 7408
    Boise, Idaho 83707
  • or fax to the appropriate Provider Relations Representative
    (See MA PAP102)

Provider Relations will forward your request to Blue Cross of Idaho's Medicare Advantage marketing specialist for review and CMS submission. We will notify you when the review is complete and if your material is approved or denied for distribution.


Policy History

Date Action Reason
January 2012 Revised Removed Flexi Blue language
September 2011 Revised Language Update
May 2008 Revised Title change

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