Clinical Solutions


CareProfile®

The CareProfile offers authorized physicians and health care providers real-time access to a consolidated view of a patient's health care service claims information from multiple payers for two years of history. This clinically relevant information complements the physician's own medical records and can be viewed by the physician at the point of care for better-informed decision-making.

 

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Epocrates

Epocrates is a drug reference tool offered by BCBSF that offers free mobile and web-based access to Epocrates to view BCBSF formularies.

 

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Availity Patient Care Summary

 

The Availity Patient Care Summary offers authorized physicians and health care providers real-time access to a consolidated view of a patient's health care service claims information from multiple payers for two years of history. This clinically relevant information complements the physician's own medical records and can be viewed by the physician at the point of care for better-informed decision-making.

 

Electronic Care Reminders

Care Reminders are clinical messages based on claims data that can be found within a Patient Care Summary  and are intended to assist with identifying opportunities to improve the health of patients. The current electronic Care Reminders are based on Healthcare Effectiveness Data and Information Set (HEDIS) and the Centers for Medicare & Medicaid Services (CMS) Star measures.

 

For the complete list of the current Care Alerts shown in the Availity Patient Care Summary Clinical Messaging section click here.

 

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Electronic Appeal

 

Buried in paperwork when you need to appeal a claim?  Florida Blue’s new capability now allows providers to file appeals electronically for previously processed claims through Electronic Appeal.

 

The benefits of Electronic Appeal include:

 

• Reduction in administrative burdens because you can  prepare and manage appeals online
• Elimination of copy, print and postage costs which saves  your practice money
• Decreased time spent on paperwork because you can submit supporting documentation electronically

 

You can access the new Electronic Appeal tool today by logging on to Availity®1; select My Payer Portals, click on the Florida Blue PASSPORTTM link, and then submit your electronic claim appeal with supporting documentation through Electronic Appeal.

 

The electronic appeal process is currently not available for the Federal Employee Program (FEP) or BlueCard® claims. Please use the current paper/written appeals process for these claims.  If you have questions about accessing the Electronic Appeal tool please contact Availity.

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