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Provider Administrative Policy

Provider Information
Policy Date
May 2008
Revised/May 2008


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.



Contracting Providers
Blue Cross of Idaho updates its Medicare Advantage plan allowances on a quarterly basis. These quarterly updates incorporate the various changes implemented by Medicare during the previous three months including new, modified and deleted codes, and their revised allowances. Because Blue Cross of Idaho updates occur quarterly, allowances will not always have a direct correlation to your local Medicare carrier, which implements updates throughout the year.

Certain Medicare Advantage allowances may approximate Medicare carrier reimbursement. Examples of these services are care that CMS may not cover and payment terms, such as multiple radiology reductions, that Blue Cross of Idaho chooses not to adopt.

Policy History

Date Action Reason
May 2008 Revised Language clarification

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