Blue Cross Medicare Advantage

blue Cross Medicare AdvantageSM. A Section of the Blues Provider Reference Manual 2018. blue Cross Medicare Advantage and blue Cross Medicare Advantage Dual Care plans are HMO, HMO-POS, PPO, and HMO Special Needs Plans provided by Health Care Service Corporation, a Mutual Legal Reserve Company (HCSC), an independent licensee of the blue Cross and blue Shield Association. HCSC is a Medicare Advantage organization with a Medicare contract and a contract with the New Mexico Medicaid program. Enrollment in HCSC's plans depends on contract renewal. Table of Contents 1. Introduction Topic Page Our Name S5. This Manual S5. Our Plans S5. Hospital Services S6. Emergency Care S7. Laboratory Services S7. 2. General Information Topic Page Eligibility and Benefits S8. Verification of Coverage S8. ID Cards S9. ID Card Sample S9. Medical Records S11. Medical Records Review S11. Standards for Medical Records S12.

10. Quality Improvement Topic Page Overview S49 Chronic Care Improvement Program (CCIP) S49 Quality Improvement Project (QIP) S49 Healthcare Effective Data and Information Set (HEDIS) S49

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  Cross, Quality, Medicare, Improvement, Blue, Advantage, Blue cross medicare advantage, Quality improvement

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