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					   A
 Anthem Professional Forum
                W H AT ’ S I N S I D E

     Anthem Blue Cross and Blue Shield
     Awards $6 Million to 16 Hospitals
 E L E C T RO N I C BU S I N E S S
     Guidelines for Filing Last Names
                                               April 2005, Volume 9, Number 4




                                                            1
                                                                Anthem Blue Cross and Blue Shield Awards $6 Million to
                                                                16 Hospitals for Major Advances in Patient Care and Safety
                                                                Sixteen hospitals around Virginia will be
                                                                awarded a total of $6 million for actively
                                                                                                                                           A monthly update for the
                                                                                                                                            health care professional
                                                                                                                                           community from Anthem
                                                                                                                                         Blue Cross and Blue Shield
                                                                                                                                            and its affiliated HMOs:
                                                                                                                                               HealthKeepers, Inc.,
                                                                                                                                        Peninsula Health Care, Inc.
                                                                                                                                     and Priority Health Care, Inc.*




                                                                                                                 College of Cardiology (ACC),Agency for
                                                                                                                 Healthcare Research and Quality
     on Claims to Anthem                                    3   working to implement nationally recog-           (AHRQ),The Leapfrog Group and the
     File Using Four- or Five-Digit                             nized care and safety practices that can         Joint Commission on Accreditation of
     Diagnosis Codes When Required                          3   save lives.The rewards are part of the           Healthcare Organizations (JCAHO).
     EDI and BlueCard® Seminars                             4   Anthem Blue Cross and Blue Shield                   For example,based on The Leapfrog
 BU S I N E S S U P DAT E                                       Quality-In-Sights.Hospital Incentive             Group analysis,as many as 1,200 lives
     Removal of Impacted Cerumen                            6   Program (Q-HIP).                                 could be saved every year in Virginia if all
     Appropriate Billing for CPT 95165                      6      The 16 hospitals that participated in         hospitals staffed their intensive care units
     Coverage Advisor™ — Helping                                the first year of Q-HIP are:                      with doctors who have special training in
     Predict Health Care Expenses                           6                                                    critical care.More than 15,000 serious
     Attention PCPs — Does Your Office                                 Carilion Medical Center
                                                                                                                 medication errors could potentially be
     Use an Electronic Medical Record                                 Centra Health
                                                                                                                 avoided if every hospital in Virginia used
     System?                                                7         CJW Medical Center
                                                                                                                 hand-held computers to order medica-
     Up-to-Date Immunization Records                                  Franklin Memorial Hospital
     — Our Members Count on You                             8                                                    tions,tests and procedures through
                                                                      Giles Memorial Hospital
     ChildhoodVaccine Reimbursement                                                                              Computerized Physician Order Entry
                                                                      Henrico Doctors’ Hospital
     Increases                                              8                                                    (CPOE).Also,according to American
                                                                      Lewis-Gale Hospital
     Anthem’s Partnership with                                                                                   Heart Association guidelines,if all
     Employers is “Time Well Spent”                         8         Memorial Regional Medical Center
                                                                                                                 Virginia hospitals prescribed aspirin
     Patient Satisfaction Survey                            9         New River Valley Medical Center
                                                                                                                 upon arrival for patients suffering heart
     Fifth Annual VIPC&S Conference                                   Riverside Regional Medical Center
                                                                                                                 attacks,hundreds of lives a year could
     Convenes in May                                   10             Sentara Norfolk General Hospital
                                                                                                                 potentially be saved.
     Anthem’s Quality Improvement                                     Sentara Virginia Beach General Hospital
                                                                                                                    These are just three of 40 clinical
     Program                                           12             St. Mary’s Hospital
                                                                                                                 measures and outcomes that Q-HIP
 D E N TA L D E TA I L S                                              UVA Health System
                                                                                                                 tracks and scores.The 16 participating
     OSHA Training Seminars on Tap                     13             VCU Health System
                                                                                                                 hospitals are receiving financial rewards
     Dental Office Seminars Available                   14             Winchester Medical Center
                                                                                                                 and incentives based on achievement of
 BULLETIN BOARD
                                                                As part of Anthem Blue Cross and Blue            the measures or the proactive strategy to
     Medical Office Seminars                            16
                                                                Shield’s commitment to improving the             meet them.
     Ancillary Providers Seminars                      18
                                                                health of the people it serves,Q-HIP                “We saw how important and innova-
 H I PA A U P D A T E
                                                                rewards hospitals for consistently follow-       tive this program was,”said Dr.Tom
     HIPAA National Provider
     Identifier Coming In 2005                          20       ing patient safety and clinical guidelines       Massaro,director for Performance
                                                                developed by national health care
 Olivia Walker, Editor                                                                                                                    continued on page 2
 We welcome your comments, questions and story                  experts.These include the American
 ideas. Send a fax to (804) 354-3885 or write:
     Anthem Blue Cross and Blue Shield
     Attn: Anthem Professional Forum
     Mail Drop VA46D, P.O. Box 27401
     Richmond, VA 23279
                                                                                 Read the Anthem Professional Forum on-line at www.anthem.com.
*The information in this newsletter pertains to all these
 entities, unless otherwise noted.
continued from page 1
Improvement,UVA Health System.“It                state.“We applaud the first 16 hospitals           care for all Virginians.”
was easy to get the physicians involved          for their leadership in partnering with us           The Q-HIP measurements and scoring
and an opportunity to demonstrate good,          in this unique hospital quality program,”         formula are separated into three sections:
quality care.There is no question that Q-        said Dr.Karen Remley,Anthem Blue                  patient safety,patient health outcomes
HIP is a driver of better hospital care.”        Cross and Blue Shield,medical director            and patient satisfaction.The charts below
   Forty-five hospitals are now enrolled          for External Quality in Virginia.“Their           show how the participating hospitals
in Q-HIP for 2005,comprising more than           participation and input has helped us             stack up for four different measurements.
75 percent of all Anthem Blue Cross and          broaden Q-HIP to include half of all hos-
Blue Shield hospital admissions in the           pitals in Virginia,thus improving hospital



       Pneumococcal Vaccination after Pneumonia based on
       Centers for Disease Control Guidelines                                   Beta Blocker at Hospital Arrival for Heart Attack
100%                                                                     100%
 90%
 80%                                                                                97.20%
           84.46%
 70%
                                                                         90%                         92.60%
 60%
 50%                                                                                                                 88%
 40%                       42.80%                                                                                                   84.70%
 30%                                     38.80%                          80%
 20%
 10%                                                    14.40%
  0%                                                                     70%
           Q-HIP High       Q-HIP        National         Q-HIP                    Q-HIP High         Q-HIP         National         Q-HIP
         (Best Achieved)   Average       Average*          Low                   (Best Achieved)     Average        Average*          Low




                                                                                Serious Complication Rate for Diagnostic Cardiac
       Aspirin Prescribed at Hospital Arrival for Heart Attack                  Catheterization
100%                                                                      8%
                                                                          7%
           97.50%                                                         6%                                                        6.50%
                           95.30%
                                           94%                            5%
                                                                                                                         5%
 90%                                                                      4%
                                                        90.30%
                                                                          3%
                                                                          2%                         2.50%
                                                                          1%
                                                                                     0.90%
 80%                                                                      0%
           Q-HIP High       Q-HIP        National         Q-HIP                    Q-HIP Low          Q-HIP         National         Q-HIP
         (Best Achieved)   Average       Average*          Low                   (Best Achieved)     Average        Averagen         High



                                                                                SOURCE:
                                                                                * JCAHO Core Measures, July 2003
                                                                                n
                                                                                  American College of Cardiology, 2003




ANTHEM    PROFESSIONAL      FORUM                                    2                                                              APRIL    2005
                                                             ELECTRONIC BUSINESS


Guidelines for Filing Last Names on Claims to Anthem
In Virginia, Anthem Blue Cross and Blue Shield has recently simplified sys-       Prefixes and Suffixes With Names:
tem edits and matching criteria for members’ and patients’ last names. The       Prefixes such as courtesy titles like “Mr.,” “Mrs.,” “Dr.,” “Rev.” and so
changes impact both electronic and paper claims, making our filing guide-         forth should NOT be used.
lines for last names for PAR and PPO claims consistent with HMO and ITS              Suffixes such as “SR,” “JR,” “III” and so forth are not necessary but
(out-of-area) claims. This means that error code1018 — indicating a last         can be used.
name conflict — will no longer be issued.
                                                                                    Electronic Claims: The 837 transaction required by the Health
    To address questions regarding last names, we are providing the fol-
                                                                                    Insurance Portability and Accountability Act (HIPAA) has a separate suf-
lowing guidelines that apply to both paper and electronic claims, unless
                                                                                    fix field, NM107, in both the 2010BA for the member’s last name and
otherwise noted. In general, names should be filed as they appear on the
                                                                                    2010CA for the patient’s last name. Punctuation should not be used.
ID card or via Point of Care if providers have online access.
                                                                                    Paper Claims: The suffix can be used, following the last name, in the
Acceptable Characters:                                                              appropriate block. Punctuation should not be used.
Use letters A through Z, apostrophe, space and asterisk. Letters should be              Acceptable Format:          SMITH JR
UPPERCASE.                                                                              Unacceptable Formats:       SMITH, JR.
   All other special characters, including the comma and period, are not                                            SMITH JR.
acceptable.                                                                                                         SMITH, JR

Correct Punctuation Usage:
An apostrophe can be used for names such as “O’KEEFE.” However,
“OKEEFE” and “O KEEFE” are both acceptable.
   Spaces can be used for names such as “VAN NESS,” “SAINT JAMES” or
“MC KESSON.” Likewise, “VANNESS,” “SAINTJAMES” and “MCKESSON”
are all acceptable.
   Asterisks should be used in place of hyphens for hyphenated last
names. For example, “SMITH-JONES” should be “SMITH*JONES.” Similarly,
“SMITHJONES” and “SMITH JONES” are both acceptable.




Attention Electronic Submitters:
File Using Four- or Five-Digit Diagnosis
Codes When Required
To ensure accurate claims processing and timely payments,
please file claims to Anthem Blue Cross and Blue Shield using
valid ICD-9 diagnosis codes that are four to five positions when
the ICD-9 book states that a fourth or fifth digit is required for
specificity.Should you file with a three-digit code and the ICD-9
book requires a four- or five-digit diagnosis code,we will consid-
er the three-digit code invalid and generate an error for the
claim — prompting delays.If you have questions,please call our
EDI specialists at (800) 991-7259.




ANTHEM     PROFESSIONAL       FORUM                                          3                                                                APRIL    2005
                                                                ELECTRONIC BUSINESS


EDI and BlueCard® Seminars Slated for May and June
To address questions about the out-of-area claims program and filing claims            Afternoon Program: BlueCard®
electronically using the electronic data interchange (EDI) process, Anthem            Last year, Anthem conducted BlueCard® seminars across Virginia — provid-
Blue Cross and Blue Shield will offer EDI/BlueCard® seminars across Virginia          ing an overview of the program, how to file claims, where to get questions
in May and June 2005. Morning sessions will address EDI with the afternoon            answered and so forth. This year, our seminars will focus on the improve-
sessions on the same day dedicated to the BlueCard® Program.                          ments made to the BlueCard® Program and the exciting new capabilities
    EDI vendors will be on hand at exhibition booths to display their prod-           that exist within Anthem Point of Care (our Web-based application) when
ucts, address your inquiries about using vendors to handle electronic trans-          requesting information for out-of-state Blue Cross and Blue Shield mem-
actions and share the benefits of electronic filing.                                    bers, including eligibility, benefits and claims status. BlueCard® experts will
                                                                                      be available to address non-claims specific questions from audience partic-
Make Plans to Attend Both Sessions
                                                                                      ipants upon completion of the presentation.
While you have the option of attending one or both sessions, we urge you
to attend both sessions for the best learning experience and the maximum              Registration Instructions
continuing education credits. Be sure to check the “ALL DAY” box.
    ALL provider types are invited, including physicians, ancillary, behavioral       Important Information — Please Read Before
health, facilities and their staffs. Don’t miss this opportunity to expand your       Registering:
EDI knowledge and also learn the latest about the BlueCard® Program.                     Register now to ensure your choice of dates and locations. These semi-
SPECIAL NOTE: A “Certificate of Attendance” for up to six (6) hours of                    nars are offered at NO CHARGE and intended for the registration and
continuing education will be awarded to each participant upon completion                 billing office staff of CMS-1500 and UB-92 submitters as well as other
of the session for submission to your professional association(s) for possi-             interested personnel. Attendance is by reservation only, and registra-
ble CEU credit.                                                                          tions are accepted as requests are received. To accommodate the
                                                                                         maximum number of provider types, we will seat up to two par-
Morning Program: Anthem Open Network (EDI)                                               ticipants from each practice entity.
Providers who would like to begin filing claims electronically to Anthem                  If you register and then cannot attend, please call (804) 678-0405
via the EDI process OR existing electronic providers who would like addi-                immediately to cancel, or at least 24 hours in advance of the seminar,
tional detailed information are invited to attend. The topics will include:              so we may offer your seat to another.
   Selecting an electronic submission approach — software vendor,                        No confirmation will be sent, so please mark your calendar and save
   clearinghouse or direct submitter.                                                    your original reservation notice. We will, however, notify you if the sem-
   Using EDI/Anthem reports.                                                             inar you select is either full or cancelled.
   Troubleshooting electronic claim issues.                                              For your comfort, we highly recommend that you bring a sweater or
   Accessing and using Anthem’s Web site, www.edi.anthem.com,                            jacket, as meeting rooms may often be cool and cannot be tempera-
   and the Anthem Companion Guide.                                                       ture-controlled.
Please note that while facilitators will address frequently asked                        At each seminar, a light continental breakfast will be available
EDI questions, claim-specific questions CANNOT be addressed in                            during morning registration. Lunch is “on your own.” An after-
these sessions.                                                                          noon snack will also be provided.
                                                                                      To register, clearly check the appropriate box for the morning program
                                                                                      (EDI), afternoon program (BlueCard®), or ALL DAY (both programs) for
                                                                                      the seminar date you select. Then, legibly complete the rest of the form
                                                                                      and fax or mail it (not both to avoid duplication) to:


                                                                                             Fax Number:         OR         Mailing Address:
                                                                                             (804) 354-2979                 Special EDI and BlueCard® Seminars
                                                                                                                            Registration
                                                                                                                            Anthem Blue Cross and Blue Shield
                                                                                                                            Mail Drop VA43C,
                                                                                                                            P. O. Box 27401
                                                                                                                            Richmond, VA 23279




ANTHEM     PROFESSIONAL         FORUM                                             4                                                                   APRIL      2005
                                                                                ELECTRONIC BUSINESS


                                                             EDI Program/BlueCard® Program
                                          Anthem-Sponsored Seminars (for providers participating with Anthem)



CENTRAL REGION                                   EASTERN REGION                                   NORTHERN REGION                                   WESTERN REGION
Wednesday, May 25, 2005                          Thursday, June 16, 2005                          Thursday, June 9, 2005                            Thursday, May 19, 2005
7:45 a.m.   –   8:30 a.m.   Registration         7:45 a.m.   –   8:30 a.m.   Registration         7:45 a.m.   –   8:30 a.m.   Registration          7:45 a.m.   –   8:30 a.m.   Registration
8:30 a.m.   –   12 p.m.     EDI Program          8:30 a.m.   –   12 p.m.     EDI Program          8:30 a.m.   –   12 p.m.     EDI Program           8:30 a.m.   –   12 p.m.     EDI Program
12 p.m.     –   1 p.m.      Lunch“on your own”   12 p.m.     –   1 p.m.      Lunch“on your own”   12 p.m.     –   1 p.m.      Lunch “on your own”   12 p.m.     –   1 p.m.      Lunch“on your own”
1 p.m.      –   1:30 p.m.   Registration         1 p.m.      –   1:30 p.m.   Registration         1 p.m.      –   1:30 p.m.   Registration          1 p.m.      –   1:30 p.m.   Registration
1:30 p.m.   –   5 p.m.      BlueCard® Program    1:30 p.m.   –   5 p.m.      BlueCard® Program    1:30 p.m.   –   5 p.m.      BlueCard® Program     1:30 p.m.   –   5 p.m.      BlueCard® Program

   Morning Program (EDI)                            Morning Program (EDI)                             Morning Program (EDI)                            Morning Program (EDI)
   Afternoon Program (BlueCard®)                    Afternoon Program (BlueCard®)                     Afternoon Program (BlueCard®)                    Afternoon Program (BlueCard®)
   ALL DAY                                          ALL DAY                                           ALL DAY                                          ALL DAY
Anthem Blue Cross and                            Crowne Plaza Hotel                               Washington Dulles Airport                         The Hotel Roanoke and
Blue Shield Headquarters —                       4453 Bonney Road                                 Marriott                                          Conference Center
Davis Center South                               Virginia Beach, VA 23462                         45020 Aviation Drive                              110 Shenandoah Avenue
2015 Staples Mill Road                           (757) 473-1700*                                  Dulles, VA 20166                                  Roanoke, VA 24016
Richmond, VA 23230                                                                                (703) 471-9500*                                   (540) 985-5900*
(804) 354-7000*




                                       *You may contact the hotels for directions; however, you must contact Anthem to register.



                                   Morning Program (EDI)                               Afternoon Program (BlueCard®)                                    ALL DAY



   Seminar Date and Time:                                                                                Location:


   Attendee #1


   Attendee #2


   Anthem Provider Number                                                                                Specialty


   Provider/Practice Name


   Address


   City/State/Zip


   Area Code/Phone Number                                                                                Area Code/Fax Number


   E-mail Address




ANTHEM          PROFESSIONAL           FORUM                                                      5                                                                                 APRIL    2005
                                                       B U S I N E S S U P DAT E


Removal of Impacted Cerumen, CPT 69210 Appropriate Billing for CPT 95165
Coverage is available if the removal of impacted cerumen is the         This code represents the preparation of vials of non-venom anti-
reason for the office visit,and the diagnosis code and documen-          gens.The most common practice is to prepare a 10 cc vial and to
tation support symptomatic impaction or occlusion of the exter-         remove aliquots of 1 cc.A physician may not bill this vial prepa-
nal auditory canal requiring a physician’s skill.Documentation          ration code for more than 10 doses per vial.Reimbursing more
of asymptomatic,non-impacted or non-obstructive cerumen not             than 10 doses per multidose vial would significantly overpay the
requiring a physician’s skill for removal is not sufficient.             practice expense component attributable to this service.
   The process requires direct visualization and removal using          Physicians may bill up to maximum of 10 doses per multidose
suction,a cerumen spoon or delicate forceps.In this scenario,the        vial but should bill for fewer than 10 doses per vial when there is
claim is submitted with CPT 69210 and ICD-9 code 380.4.If any           less than 10 cc in the vial.If medically necessary,physicians may
other diagnosis code is submitted,Anthem will reject the claim,         bill for preparation of more than one multidose vial.This is the
indicating a conflict with the diagnosis and procedure code.             case of mold and pollen antigens that cannot be mixed together.
   E&Ms will continue to deny incidental to 69210.




Coverage Advisor™ — Helping Predict Health Care Expenses
We want to share with you information about a newly available              With Coverage Advisor™,members also have access to the
tool on our Web site at www.anthem.com that enables members             Treatment Decision Guide and the Hospital Comparison tool.
to quickly estimate their family’s predicted health care expenses       Using the Treatment Decision Guide,members can determine
over the next year through an easy and interactive step-by-step         key questions to ask their physicians,learn more about commu-
tool — Subimo® Coverage Advisor™.                                       nity resources and identify issues to consider.
   Members create profiles,and Coverage Advisor™ will then                  With the Hospital Comparison tool,members can learn how
estimate how many office visits,prescriptions and other medical          one hospital compares to another for procedures performed,
services each family member may expect to receive.Coverage              complication rates and critical resources,such as intensive care
Advisor will also provide typical costs associated with these           units and the latest technology.
services to help members gain an overall sense of a family’s
anticipated annual medical costs.




ANTHEM   PROFESSIONAL     FORUM                                     6                                                         APRIL   2005
                                                                 B U S I N E S S U P DAT E


Attention PCPs — Does Your Office Use an Electronic Medical Record System?
Many health care institutions in the United States are adopting informa-           Advantages of an EMR System
tion systems that provide more accurate and timely information regarding           Information technology is proving to be a vital element in the administra-
patient care. An electronic medical record (EMR) system was introduced as          tion of health care. Benefits realized by an EMR system include increased
a way to facilitate a centralized patient information repository. To support       patient safety and quality of care being rendered, immediate and remote
this nationwide effort, an EMR system is now an indicator for Anthem’s             access to patient records, automated clinical guidelines, direct access to
2005 Performance Extra Program — a PCP-based program designed to                   international databases, automated referral and prescription generation,
reward excellent performance.                                                      statistical reporting, multiple data views and reduction in office-related
    To help ensure that you receive appropriate credit under the Performance       administrative costs and tasks.
Extra Program, let Anthem know if you are using EMR software and which                 As a reminder, PCPs must have fully implemented an electronic medical
software and features. For your convenience, we have included a short evalu-       record system by Dec. 31, 2005, in order to qualify for this indicator under
ation form in this edition of the Anthem Professional Forum for you to com-        the Performance Extra Program.
plete if you are using EMR software. Please complete the form right away
and return via facsimile — to (804) 354-3302, attention William McMahon.


                                                   Fax to (804) 354-3302, Attention: William McMahon


   Physician Name


   Physician License Number


   Group Name


   Group Tax Identification Number

   Electronic Medical Records (EMR) System Attributes: (Check all that apply.)
       Decision support tool using evidence-based medicine for pharmacy management (to include but not limited to the following):
          Drug recommendations using calculated or inferred knowledge (drug choice guided by lab results, drug dosing and body weight)
          Medication alerts for the prevention of adverse drug events including complex interaction checks (drug-drug, drug-allergy, drug-disease)
          Ability to update the system in a timely fashion for medications withdrawn from the market or changes in indications
          Medication recommendations based on diagnoses in the EMR

       Formulary management tool
          Ability to accept Anthem formularies
          Ability to direct drug utilization toward generic options and formulary drugs
          Ability to capture copayments
          E-faxing prescription (e-prescribing) capability

       Chronic disease management tool
       Preventive medicine tool
       Links to diagnostic providers — labs and X-rays
       Database capability with ability to query
       Ambulatory computerized physician order entry system
   System Software Description: (Please provide any additional information you may deem helpful.)




ANTHEM     PROFESSIONAL        FORUM                                           7                                                                 APRIL   2005
                                                              B U S I N E S S U P DAT E


Up-to-Date Immunization Records — Our Members Count on You
Physicians play a vital role in educating patients about the ben-                 Anthem Blue Cross and Blue Shield and our affiliated HMOs
efits of life-long,life-protecting vaccines and the importance of              offer members timely information and targeted reminders to
up-to-date immunization records.Additionally,pediatricians can                underscore the value of appropriate immunizations,ensuring
have a positive impact by urging parents to have their infants                children,teens and adults are protected.To be eligible for pro-
and young children receive the recommended immunizations on                   motional incentives,members are encouraged to request copies
time by age two.Childhood immunizations are an integral part                  of immunization records from their physicians and send copies
of the Performance Extra Program and are also a part of the                   to Anthem.When physicians accommodate members’requests
medical record data collection through the Health Plan                        for copies of records,this will help abbreviate the annual
Employer Data and Information Set (HEDIS).                                    HEDIS chart review process in spring 2006 — minimizing dis-
                                                                              ruptions to physicians’offices.



Childhood Vaccine Reimbursement Increases
Anthem recently increased the fee allowances for the
following vaccines:

  CPT Code Description                         Allowance Effective Date

  90734     Meningococcal conjugate vaccine $89.00        03-01-2005
  90723     Diptheria, tetanus toxoids,          $75.00   03-23-2005
            acellular pertussis vaccine,
            Hepatitis B, and poliovirus vaccine,
            inactivated (Dtap-HepB, IPV)




Anthem’s Partnership with Employers is “Time Well Spent”
In our ongoing efforts to help members live healthier lives,                    Benefit design and promotion (focused on health and well-
Anthem Blue Cross and Blue Shield has several areas of focus                    ness services).
for 2005 — heart health,physical activity,early detection of                    Employer Engagement Programs (foster supportive environ-
cancer,healthy eating,diabetes and flu and cold prevention.                      ment to affect change).
    Anthem is partnering with a number of employer groups to
                                                                                Onsite health screenings (to identify employees with indica-
bring health promotion and health screenings to the workplace.
                                                                                tors of chronic diseases so they can receive education,follow-
“Time Well Spent” is a platform that is designed to help mem-
                                                                                up and encouragement to consult their physicians if needed).
bers reach and maintain their highest level of wellness. Anthem
                                                                                Worksite Turnkey Programs (such as Walking WorksSM,
is working with employer groups to help improve the health of
                                                                                a tool-kit for employers to develop and implement walking
employees by using the following:
                                                                                programs).
                                                                                Quarterly health communications materials (to integrate
                                                                                into existing communications throughout the workplace).
                                                                              As a result of the workplace health promotion programs,you
                                                                              may receive questions from patients regarding their health con-
                                                                              cerns and courses of treatment.




ANTHEM    PROFESSIONAL       FORUM                                        8                                                       APRIL   2005
                                                                   B U S I N E S S U P DAT E


Patient Satisfaction Survey
Anthem values the health services our members receive from                          2004 Survey Scores
primary care physicians (PCPs) and their office staff.Therefore,                     The following table compares the average scores for each ques-
Anthem Blue Cross and Blue Shield and our affiliated HMOs                            tion from the 2003 and the 2004 surveys.The survey results are
conduct patient satisfaction surveys,allowing our members to                        scored on a scale of 1 to 5,with 5 being excellent.As a result of
evaluate the services they receive.                                                 your efforts,we have seen an improvement in our members’over-
   As in the past,we are sharing survey scores in this edition of                   all satisfaction with their PCPs.
the Anthem Professional Forum.


   ABOUT THE VISIT                                                      2003        2004
   How long you waited to get an appointment                             3.95       3.98
   Getting through to the office by phone                                 3.72       3.75
   Length of time waiting at the office                                   3.53       3.59
   Time spent with the person you saw                                    4.00       4.04
   Explanation of what was done for you                                  4.12       4.15
   The technical skills (thoroughness, carefulness, competence)
      of the person you saw                                              4.26       4.28
   The personal manner (courtesy, respect, sensitivity, friendliness)
      of the person you saw                                              4.40       4.41
   Convenience of the office hours                                        3.97       4.00
   The personal manner (courtesy, respect) of the physician’s
      administrative staff                                               3.96       3.98
   The personal manner of the nurses                                     4.16       4.16
   The explanation you received about your condition,
      course of treatment and expected outcomes                          4.17       4.19
   The suggestions, written materials and/or advice offered to you
      about ways to improve your health                                  3.95       3.99
   The coordination of care and appropriate specialist referrals
      offered to you by your primary care physician                      4.12       4.14
   OVERALL
   Would you recommend this primary care physician                       4.58       4.57
   How would you rate your last office visit                              4.10       4.11
   Rate the effectiveness of this primary care physician
      in the management of your care                                     4.20       4.22



Patient Satisfaction Survey 2005
The 2005 surveys will be mailed to our members beginning in May. This
mailing includes visits from January 2005 through April 2005.
   Beginning in June,we will mail the surveys on a monthly basis.In
order to receive a physician summary report,a minimum of 15 surveys
must be returned.Please take this opportunity to remind your patients to
complete the surveys and return them promptly.
   If you have any questions concerning the survey,please contact your
physician network consultant.



ANTHEM    PROFESSIONAL         FORUM                                            9                                                        APRIL   2005
                                                                  B U S I N E S S U P DAT E


Fifth Annual VIPC&S Conference Convenes in May
“Excellence in Patient Safety Award” to be Presented
                                                                                         2005 VIPC&S Conference Information
Please join health care professionals across the commonwealth as they
gather on May 25, 2005, at the Greater Richmond Convention Center in                     Date:                                   Wednesday, May 25, 2005
Richmond, Va., for the fifth annual conference for Virginians Improving                   Where:                                  Greater Richmond
Patient Care and Safety (VIPC&S). The theme — “Enhancing Health Care                                                             Convention Center
Delivery: A Patient-Centered Paradigm” — explores tools required to                                                              Downtown Richmond
ensure that health care is provided in an efficient, effective, safe manner in                                                    300 North 5th Street
hospitals, outpatient clinics and physician offices.                                                                              Richmond, VA 23219
    Additionally, the conference focuses on proven effective and reliable
tools that aid in preventing or reducing medical errors — tools that allow               Registration Fee:                       $50.00 per participant for
for the integration of technology, communications and best practices. As                                                         health care professionals
in the past, Anthem Blue Cross and Blue Shield is the flagship sponsor for                                                        $25 for students
the conference.                                                                                                                  $100 for out-of-state participants
                                                                                         (Please note that registration fees have NOT increased since the conference began
“Excellence in Patient Safety Award”                                                     in 2001 despite the distinguished line-up of nationally recognized speakers.)

New this year, an “Excellence in Patient Safety Award” will be presented,
recognizing the oral presentation that best exemplifies the effective appli-          Registration
cation of patient safety principles in a clinical care environment. All award
                                                                                     A registration form is included in this edition of the Anthem Professional
applicants will present their findings in a poster session at the conference,
                                                                                     Forum. For your convenience, you may register one of three ways — mail,
with three finalists selected to present their findings during an afternoon
                                                                                     fax or online. For multiple registrations or special assistance, call (804)
breakout session. Conference attendees will cast votes to select the winner.
                                                                                     643-6631.
Conference Speakers                                                                      When registering, please complete the registration form and include
                                                                                     payment. Visit the VIPC&S Web site at www.vipcs.org for conference details.
The conference will host a nationally recognized lineup of
speakers, including keynote speaker Dr. Atul Gawande, a
                                                                                                              Register by Mail:
Harvard Medical School professor and staff writer for the
                                                                                                              Lara W. Knowles
New Yorker magazine. He is a gifted writer as illustrated
                                                                                                              VIPC&S Planning Committee
in his first collection of essays, Complications: A
                                                                                                              1200 East Clay Street
Surgeon’s Notes on an Imperfect Science, as Dr.
                                                                                                              Richmond, VA 23219
Gawande describes both medical mishaps and awe-inspir-
ing surgical techniques with authoritative ease. Dr.                                                          Register by Fax:
Gawande received his undergraduate degree from Stanford                                                       Fax Number: (804) 788-9987
University in 1987and a M.A. degree from Oxford                                                               Register Online:
University in 1989. In 1995, he earned his medical degree                                                     Log on to Web site at: www.vipcs.org
from the Harvard Medical School and is a Rhodes
Scholarship recipient.                                         Dr. Atul Gawande,
                                                               Physician and Author

Other invited speakers for the conference include:                                   Additional Information
   Frank Christopher                      Diana Artemis                              Visit the VIPC&S Web site at www.vipcs.org to view additional information
   Producer,                              Founding Advisor,                          about the upcoming conference. You’ll find the entire conference agenda,
   2006 PBS Documentary                   Consumers Advancing Patient                speakers and registration information and forms. Information regarding
   “Remaking American Medicine”           Safety and Volunteer;                      continuing education credits is also available on the Web.
                                          Patient & Family Advisory
   Beverly Johnson                                                                   VIPC&S believes that creating a forum for sharing knowledge about health care errors is
                                          Council, NPSF                              essential for improving patient safety and assuring public trust, and that the interest of the
   President and CEO,
                                                                                     public can be best served by adopting the most effective evidence-based methods available
   Institute for Family Centered Care     James B. Conway                            to prevent avoidable patient injury due to medical errors. The VIPC&S annual conference
                                          Executive Vice President and               strives to bring together health care organizations and leaders from diverse disciplines who
   Charles Darby                                                                     share a commitment to advancing patient safety.
                                          Chief Executive Officer,
   Agency for Healthcare Research
                                          Dana Farber Cancer Institute;
   and Quality
                                          IHI Representative

                                          Anton J. Kuzel, MD, MHPE
                                          Professor and Chair,
                                          Department of Family Medicine,
                                          Virginia Commonwealth University



ANTHEM     PROFESSIONAL        FORUM                                            10                                                                                APRIL      2005
                                        ENHANCING HEALTH CARE DELIVERY:
                                           A Patient-Centered Paradigm
                                   May 25, 2005 • Greater Richmond Convention Center

    CONFERENCE REGISTRATION

    Mr./Ms./Mrs./Dr.
                                  First Name                                    Last Name                                 MI


    Profession (check 1 or more):               M.D.         R.N.         Ph.D.        M.P.H.           Pharmacist         Other:


    Title                                                                                      Organization



    Address



    City                                         State                                         Zip


    Phone                                        Fax                                           E-mail

    I would like to attend the following breakout session:                      (3:00 - 4:30 PM — PLEASE CHOOSE 1)

            Track 1 - Patient Safety Fellowship Showcase                             Track 2 - Virginia-Based Best Practices
            Track 3 - A Conversation About Preventable                               Track 4 - “Remaking American Medicine:” Expanding
                      Problems in Primary Health Care                                          the Model of the New Practitioner, Hospital,
                      Anton J. Kuzel, M.D., M.H.P.E.                                           and Patient to Entire Communities
                                                                                               Frank Christopher and Lee Allen

    Conference fee: $50 for VA health care professionals and consumers
                    $25 for Virginia students
                    $100 Out-of-state fee

    PAYMENT METHOD

           Enclosed is check #                              in the amount of $                                (Payable to “VIPC&S”)

           Charge my credit card:                VISA                     MasterCard

    #                                                                               in the amount of $

    The name on the card is                                                         The expiration date is

    CANCELLATION POLICY: Because of the nominal cost of this conference, there will be NO REFUNDS. Conference registrations are, however,
    transferable. If, for any reason, the event is cancelled, we do not accept responsibility for covering airfare, hotel or other costs incurred.


         YOU CAN REGISTER:                1. ONLINE: www.vipcs.org
                                          2. BY MAIL: Lara W. Knowles, VIPC&S Conference Planning Committee
                                                      1200 East Clay Street, Richmond, VA 23219
                                          3. BY FAX:  (804) 788-9987 (If you wish to fax this form and you will be paying by check,
                                                      please indicate that the check is in the mail.)

                                                Space is limited, so please register today!
                         If special accommodations are needed, please contact Lara Knowles at (804) 643-6631.
                 For more details on speakers and the program, see our Web site at www.vipcs.org or call (804) 643-6631.




ANTHEM      PROFESSIONAL      FORUM                                            11                                                                    APRIL   2005
                                                          B U S I N E S S U P DAT E


Anthem’s Quality Improvement Program
Anthem’s Quality Improvement (QI) Program seeks to ensure                 Improving Service
that our members receive the best possible medical care and                 Anthem evaluates member satisfaction on an annual basis to
levels of service.                                                          identify areas for improvements such as coverage,customer
   Feedback from our members and providers is an important                  service and physician networks.
aspect of the QI Program,as it helps us to determine opportunities
                                                                            To ensure a broad network of providers,Anthem monitors
for improvement.WithAnthem’s QI program,we continue to seek
                                                                            the number of physicians in our networks,as well as the
new ways to provide new levels of excellence with respect to mem-
                                                                            geographic distribution of those physicians.
bers and providers.To this end,here are some of the waysAnthem is
                                                                            Striving to improve access for our members to quality care,
working to improve our service to you and our members.
                                                                            Anthem monitors the accessibility of physicians.This
Improving Care                                                              includes evaluating how long it takes members to receive
   Anthem offers disease management programs for chronic                    appointments with network physicians and evaluating after-
   conditions such as asthma and diabetes to our Anthem                     hours accessibility of network physicians.
   HealthKeepers members.These programs help members                           To that end, Anthem’s provider agreements stipulate that
   better manage their health and encourage them to follow                  medical care must be available to members 24 hours a day,
   recommended treatment plans.                                             seven days a week.In addition,the agreements require the
   Anthem annually collects Health Plan Employer Data                       timely scheduling of appointments.Routine appointments,
   Information Set (HEDIS“) data for our HMOs.Measures                      for example,must be scheduled within two weeks of the
   track the use of key preventive services like mammography,               member’s request.Preventive care,including routine exams,
   Pap smears and childhood immunizations.Other measures                    must be performed within 60 days of the member’s request.
   address care rendered for chronic conditions such as depres-             Anthem reviews reasons for member complaints and appeals
   sion,high blood pressure and asthma.Anthem continuously                  to determine areas for improvement in health plan opera-
   works to improve these rates by sharing this information                 tions,customer service,physician networks and so on.
   with our network providers often in conjunction with clinical
                                                                            To enhance service levels to providers and members,Anthem
   practice guidelines.
                                                                            monitors ongoing service-related indicators,such as tele-
   Anthem evaluates the continuity and coordination of care                 phone wait times,claims processing cycle times,the percent-
   between primary care physicians and specialists,as well as               age of member identification cards completed within specific
   between primary care physicians and behavioral health                    time frames and so forth.
   providers.
                                                                          If you would like more information about these and other
   Anthem adopts clinical practice guidelines with input from             elements of our QI program,or if you would like information
   participating physicians and monitors compliance with                  regarding achievements of the QI program,please write:
   selected guidelines.
                                                                            Anthem Blue Cross and Blue Shield
   As appropriate,Anthem reviews the medical records of                     Quality Improvement Coordinator
   physicians,offering suggestions for improvements.Examples                Mail Drop 43K
   of evaluative criteria include:                                          2221 Edward Holland Drive
                                                                            Richmond, VA 23230
   •   Confidentiality of medical records is maintained.
   •   Medical history is appropriately documented.
   •   Preventive services are appropriately recorded.
   •   Continuity of care between the primary care physician
       and other providers is documented.




ANTHEM    PROFESSIONAL     FORUM                                     12                                                      APRIL   2005
                                                                     D E N TA L D E TA I L S


Attention Dental Professionals:
OSHA Training Seminars on Tap for July and September
TThe Occupational Safety and Health Administration (OSHA) requires that                Registration
all dental professionals and staff receive training and education on current           Reservations are required, as seating is limited. Registration is
OSHA requirements each year. Furthermore, individuals must receive infor-              accepted as requests are received, so please register early. There
mation on standards for blood-borne pathogens and other changes in                     will be NO CONFIRMATION of your registration; however, if the session
OSHA requirements.                                                                     you are requesting is filled to capacity, Anthem will notify you. Please take
    As a courtesy to dental and oral surgery offices that participate in                time now to select a session and complete the registration form.
Anthem’s dental networks, Anthem will offer the OSHA seminars — at
no charge — in July and September in locations across the state. Please                Seminar Topics
make plans now to attend a session. Dentists, dental hygienists and dental             Anthem will review the following general categories in the seminars:
assistants completing an Anthem OSHA seminar will receive continuing
                                                                                       1. Record Keeping Requirements – Includes information about the
dental education (CDE) credits.
                                                                                          training, exposure control, hazard communication, and emergency
* Anthem Blue Cross and Blue Shield has been designated and approved by the
Virginia Academy of General Dentistry (AGD). This sponsor’s formal CDE pro-               action.
grams are accepted by the AGD for membership maintenance, fellowship and               2. Hazard Communication – Includes information on proper handling of
mastership credits. The current term of approval extends from March 1, 2004, to
March 1, 2008.                                                                            hazardous chemicals.

The Anthem-sponsored seminars address OSHA requirements when you:                      3. Emergency Action – Provides detailed information on how to respond
                                                                                          to emergency situations for employee safety.
   Hire new employees.
                                                                                       4. General Duty Safety – Reviews Ergonomics and other employee
   Document employee training to meet OSHA standards.
                                                                                          health and safety issues.
   Report incidental exposure accidents and other situations according to
                                                                                       5. Blood Borne Pathogens – Explains how to protect yourself and your
   legal requirements.
                                                                                          employees from blood and other body fluid contamination.


                                       OSHA Certification Dates and Locations. Please Indicate Choice.
                                                          (for providers participating with Anthem)
       MANASSAS                                                RICHMOND                                                  NEWPORT NEWS
       July 19, 2005 (Tuesday)                                 July 20, 2005 (Wednesday)                                 July 21, 2005 (Thursday)
       Comfort Suites – Manassas                               Anthem Blue Cross and Blue Shield                         Omni Hotel – Newport News
       Ballroom                                                Davis Center – Tidewater Room                             Rainbow Ballroom
       7350 Williamson Boulevard                               2015 Staples Mill Road                                    1000 Omni Boulevard
       Manassas, VA 20109                                      Richmond, VA 23230                                        Newport News, VA 23601
       (703) 686-1100*                                         (804) 354-2338*                                           (757) 873-6664*
       12:30 – 1:30 p.m. Sign-in                               12:30 – 1:30 p.m. Sign-in                                 12:30 – 1:30 p.m. Sign-in
       1:30 – 4:30 p.m. OSHA Session                           1:30 – 4:30 p.m. OSHA Session                             1:30 – 4:30 p.m. OSHA Session

       BRISTOL                                                 ROANOKE                                                   CHARLOTTESVILLE
       September 20, 2005 (Tuesday)                            September 21, 2005 (Wednesday)                            September 22, 2005 (Thursday)
       Holiday Inn Hotels and Suites                           Clarion Hotel Roanoke Airport                             Holiday Inn
       Ballroom A                                              Ballroom A, B, C                                          University Area & Conference Center
       3005 Linden Drive                                       3315 Ordway Drive, NW                                     Presidential Ballroom
       Bristol, VA 24202                                       Roanoke, VA 24017                                         1901 Emmett Street
       (276) 466-7725*                                         (540) 362-4500*                                           Charlottesville, VA 22901
       12:30 – 1:30 p.m. Sign-in                               12:30 – 1:30 p.m. Sign-in                                 (434) 977-7700*

       1:30 – 4:30 p.m. OSHA Session                           1:30 – 4:30 p.m. OSHA Session                             12:30 – 1:30 p.m. Sign-in
                                                                                                                         1:30 – 4:30 p.m. OSHA Session
   Seating is limited. Please submit your registration as soon as possible.
   *You may contact the hotels for directions; however, you must contact Anthem to REGISTER for these seminars.


   Name of Dental Office                                                                     Name of Attendee

   Provider Number                                                                          Name of Attendee

   Phone Number (Including Area Code)                                                       Name of Attendee
   You may fax your registration to (804) 354-3029, Attention OSHA Seminar Registration, or mail your registration to the following address:
                        Anthem Services, Inc. • P.O. Box 27401 • OSHA Registration/Mail Drop VA43A • Richmond, VA 23279
      There will be NO CONFIRMATION of your registration; however, if the session you are requesting is filled to capacity, Anthem will notify you.


ANTHEM     PROFESSIONAL            FORUM                                          13                                                                     APRIL   2005
                                                                                   D E N TA L D E TA I L S


Dental Office Seminars Available
Please make plans now to attend one of Anthem’s dental office seminars                                 Registering for Dental Office Seminars
offered at no charge to participating dental and/or oral surgery profession-                          To register for a seminar, please submit your completed reservation form
als and their office staff. The informative seminars address claims filing,                             either by fax or by mail to:
current Anthem updates, Anthem Point of Care and much more.
                                                                                                              Fax Number:             OR            Mailing Address:
Special Note:                                                                                                 (804) 354-3029                        Anthem Blue Cross and Blue Shield
Anthem’s dental office seminars should not be confused with the                                                                                      Attention: Dental Office Seminars
seminars offered through the annual Occupational Safety and Health                                                                                  Mail Drop VA43A
Administration (OSHA). We will offer OSHA seminars in July, so please                                                                               P.O. Box 27401
the schedule in this edition of the Anthem Professional Forum.                                                                                      Richmond, VA 23279

                                                                                                      Cancellations
                                                                                                      If you register and then find you cannot attend, please call (804) 354-2338
                                                                                                      to cancel as soon as possible or at least 24 hours in advance of the semi-
                                                                                                      nar. We can then assign your seat to another. Please note that your reg-
                                                                                                      istration will not be confirmed, but you will be contacted if the ses-
                                                                                                      sion you have selected is full.




                                                    Dental Office Seminar Registration Form
                                                      (for providers participating with Anthem)
    To register for a dental office seminar, fill out this form completely and fax OR mail it to:            FAX:   (804) 354-3029
    OR MAIL:      ANTHEM Blue Cross and Blue Shield, Attn: Dental Office Seminars, Mail Drop VA43A, P.O. Box 27401, Richmond, VA 23279


PLEASE NOTE THERE WILL BE NO CONFIRMATION OF YOUR REGISTRATION.                                          Attendance is by reservation only, and we can accommodate up to two people from each
However, we will notify you if the seminar is either FULL or CANCELLED.                                  dental office. If you register and then cannot attend, please call (804) 354-2338 to cancel
                                                                                                         24 hours in advance of the seminar or as soon as you know.
When registering, please remember:
   These free seminars are for the office personnel of DDSs and DMDs only. Other physician                Because comfort levels vary and meeting rooms cannot be temperature controlled,
   specialties, such as mental health, MDs and DOs receive separate training and will be noti-           we suggest bringing a sweater or light jacket.
   fied of those seminars.


SEMINAR DATE AND TIME                                                                                 LOCATION


ATTENDEE #1


ATTENDEE #2


PROVIDER NAME


ANTHEM PROVIDER NUMBER                                                                                SPECIALTY


ADDRESS


CITY/STATE/ZIP


PHONE NUMBER (INCLUDING AREA CODE)                                                                    FAX NUMBER (INCLUDING AREA CODE)


E-MAIL ADDRESS




ANTHEM           PROFESSIONAL          FORUM                                                     14                                                                                APRIL      2005
                                                                             D E N TA L D E TA I L S


2005 Dental Office Seminar Schedule
 DATE                TIME                  REGION         LOCATION/ADDRESS

   May 10            10 a.m. – 12 p.m.     Northern       Culpeper County Library, Meeting Room, 271 Southgate Shopping Center, Culpeper, VA 22701

 * May 24            10 a.m. – 12 p.m.     Central        Anthem Blue Cross and Blue Shield, Davis Center, Virginia Room, 2015 Staples Mill Road, Richmond, VA 23230

   June 7            10 a.m. – 12 p.m.     Northern       Samuels Public Library, 538 Villa Avenue, Front Royal, VA 22630

 * June 23           10 a.m. – 12 p.m.     Eastern        Sentara Virginia Beach General Hospital, Health Education Center, Room A, 1060 1st Colonial Road,
                                                          Virginia Beach, VA 23454

 * July 12           10 a.m. – 12 p.m.     Northern       Anthem Blue Cross and Blue Shield, Chantilly Office, 3800 Concorde Parkway, Chantilly, VA 22021
 * July 26           10 a.m. – 12 p.m.     Western        Anthem Blue Cross and Blue Shield, Roanoke Office, NBC Bank Building, 111 Franklin Road, 3rd Floor, Room A,
                                                          Roanoke, VA 24011
                                                          Note: Call Anthem at (804) 354-2338 for parking information.

 * August 9          10 a.m. – 12 p.m.     Western        Johnston Memorial Hospital, 3rd Floor Conference Room B, 351 Court Street, NE, Abingdon, VA 24210

   August 23         10 a.m. – 12 p.m.     Eastern        Chesapeake Central Library, 298 Cedar Road, Meeting Room #2, 1st Floor, Chesapeake, VA 23322

 * September 13      10 a.m. – 12 p.m.     Central        Mary Washington Hospital, Classroom B, 1001 Sam Perry Boulevard, Fredericksburg, VA 22401

 * Refreshments will be provided in these sessions only




ANTHEM        PROFESSIONAL         FORUM                                                 15                                                                        APRIL   2005
                                                                     BULLETIN BOARD


Anthem’s Medical Office Seminars Off to a Good Start
Anthem’s 2005 medical office seminars are already under way and off to a
good start in all regions. Offered at no charge, the seminars are designed               Registration
for participating new and existing network physicians, such as medical                   Central, Eastern and Northern Regions ONLY
doctors (MD), doctors of osteopathy (DO) or doctors of podiatric medicine                • FAX:   (804) 354-2979

(DPM). Please note that the medical office seminars should not be                           OR
confused with Anthem’s upcoming BlueCard® and electronic filing                           • MAIL: Anthem Blue Cross and Blue Shield
                                                                                                 Attn: Medical Office Seminars
seminars. Our medical office seminars address:                                                    Mail Drop VA43C
    Claims filing                                                                                 P. O. Box 27401
                                                                                                 Richmond, VA 23279
    Anthem/WellPoint merger
                                                                                         Western Region ONLY
    Commonwealth of Virginia group (COVA Care)                                           To register for a medical office seminar in the western
    Federal Employee Program (FEP)                                                       region, submit your completed form:

    Medicaid HMO Expansion                                                               • FAX:   (540) 853-3065
                                                                                           OR
    Medicare Advantage
                                                                                         • MAIL: Anthem Blue Cross and Blue Shield
    Performance Extra Program                                                                    Attn: WESTERN Medical Office Seminars
                                                                                                 Mail Drop VAG5C
    Utilization Management                                                                       P. O. Box 13047
    Point of Care                                                                                Roanoke, VA 24030

    Other timely updates
The schedule for the northern, eastern, central and western regions is
presented below.


                                          Medical Office Seminar Registration Form
PLEASE NOTE THERE WILL BE NO CONFIRMATION OF YOUR REGISTRATION.                          In order to allow as many practices to be represented as possible, we can
We will only notify you if the seminar is either FULL or CANCELLED.                      accommodate up to two people from each medical practice.

IMPORTANT! When registering, please remember:                                            If you register and then cannot attend, please call to cancel at least 24
   These free seminars are for MDs, DOs and DPMs only, and their office per-              hours in advance or as soon as you know to allow us time to assign your
   sonnel. Non-physician specialties, such as mental health and dental offices,           seat to someone else. Call (804) 678-0405 to cancel seminar registrations
   receive separate training and will be notified of those seminars.                      in the central, eastern and northern regions. For the western region, call
                                                                                         (540) 853-5077 to cancel.
   Please register in your appropriate region and for the desired date/time
   of seminar.                                                                           For your comfort, we urge you to bring a sweater or jacket, as seminar
                                                                                         meeting rooms are often cool and cannot be temperature-controlled.
   Registration is either by fax OR mail, NOT both, to avoid duplication.
                                                                                         All sessions are “Brown bag lunch” or “on your own” unless otherwise
                                                                                         specified. Beverages will be provided.


SEMINAR DATE AND TIME                                                                 LOCATION


ATTENDEE #1


ATTENDEE #2


PROVIDER NAME


ANTHEM PROVIDER NUMBER                                                                SPECIALTY


ADDRESS


CITY/STATE/ZIP


PHONE NUMBER (INCLUDING AREA CODE)                                                    FAX NUMBER (INCLUDING AREA CODE)


E-MAIL ADDRESS




ANTHEM           PROFESSIONAL   FORUM                                            16                                                                   APRIL    2005
                                                                    BULLETIN BOARD


2005 Medical Office Seminars — WESTERN Region Only
 DATE             TIME                     REGION     LOCATION/ADDRESS

 May 3            10 a.m. – 1 p.m.         Western    Lynchburg Public Library, 2315 Memorial Avenue, Lynchburg, VA 24501

 May 6 ED – FILLED TO–CAPACITY
                1 p.m. 4 p.m.              Eastern    Chesapeake General Hospital, Lifestyle and Fitness Center, 800 Battlefield Boulevard North, Chesapeake, VA 23320
  CLOS
 May 12           10 a.m. – 1 p.m.         Western    Four Points Sheraton, 1400 East Market Street, Harrisonburg, VA 22801

 May 13           1 p.m. – 4 p.m.          Central    Community Memorial Health Center, Education Center, 1st Floor, Room 101, Buena Vista Circle, South Hill, VA 23970

 June 1           1 p.m. – 4 p.m.          Eastern    Shore Memorial Hospital, 6th Floor Board Room, 9507 Hospital Avenue, Nassawadox, VA 23413

 June 7           10 a.m. – 1 p.m.         Western    Wythe County Community Hospital, Wythe/Bland Conference Center (Beside Hospital) 600 West Ridge Road,
                                                      Wytheville, VA 24382

 June 8           10 a.m. – 1p.m.          Western    Clinch Valley Medical Center, Classroom 2, Basement Level, 2949 West Front Street, Richlands, VA 24641
 June 15          10 a.m. – 1p.m.          Western    Roanoke Higher Education Center, 108 North Jefferson Street, Roanoke, VA 24016
                                                      Validated parking available in the Gainsboro Parking Garage adjacent to building

 June 22          10 a.m. – 1 p.m.         Western    Holiday Inn Staunton, Ballroom, Interstate 81, Exit 225, 152 Fairway Lane, Staunton, VA 24401

 June 23          10 a.m. – 12:30 p.m.     Central    Bon Secours Memorial Regional Medical Center, Medical Office Building 1, 1st Floor, 8220 Meadowbridge Road,
                                                      Mechanicsville, VA 23116,

 June 30          12 p.m. – 3 p.m.         Eastern    Riverside Conference Center, Warwick Medical and Professional Center, Building 6, Suite B, 12420 Warwick Boulevard,
                                                      Newport News, VA 23606

 July 13          10 a.m. – 1 p.m.         Western    Johnston Memorial Hospital, 3rd floor Conference Center, Room C, 351 North Court Street, Abingdon, VA 24210

 July 15          1 p.m. – 4 p.m.          Northern   Virginia Hospital Center (formerly Arlington Hospital), John T. Hazel Auditorium, 1701 N. George Mason Drive,
                                                      Arlington, VA 22205

 July 19          1 p.m. – 4 p.m.          Eastern    Bon Secours DePaul Hospital, Price Auditorium, 150 Kingsley Lane, Norfolk, VA 23505

 July 26          1 p.m. – 4 p.m.          Western    Norton Community Hospital, Day Room, 100 15th Street, Norton, VA 24273

 August 17        10 a.m. – 1 p.m.         Western    Wellmont Bristol Regional Medical Center, Magnolia Room, 1 Medical Park Boulevard, Bristol, TN 37620

 August 23        1 p.m. – 4 p.m.          Northern   Prince William Hospital, 4th Floor Conference Rooms A & B, 8700 Sudley Road, Manassas, VA 20110

 August 24        10 a.m. – 1 p.m.         Western    Carilion New River Valley Medical Center, Fireside Room A, Radford, VA 24141

 September 16     10 a.m. – 1 p.m.         Western    Twin County Community Hospital, 200 Hospital Drive, Twin County Room, Galax, VA 24330

 September 20     9:30 a.m. – 12:30 p.m.   Central    CJW Medical Center, Johnston-Willis Campus, 1st Floor, Main Hospital Auditorium, 1401 Johnston-Willis Drive,
                                                      Richmond, VA 23235

 September 29     10 a.m. – 1 p.m.         Western    Danville Regional Health System, Hoover Auditorium, 142 South Main Street, Danville, VA 24541

 October 7        12 p.m. – 3 p.m.         Central    Southside Regional Medical Center, 1st Floor, Private Dining Room, 801 South Adams Street, Petersburg, VA 23803

 November 8       1 p.m. – 4 p.m.          Northern   Loudoun Hospital, Loudoun Professional Office Building, Conference Rooms A&B, 44055 Riverside Parkway,
                                                      Leesburg, VA 20176

 * Western region seminars are indicated in “blue.”




ANTHEM       PROFESSIONAL       FORUM                                            17                                                                            APRIL    2005
                                                                           BULLETIN BOARD


Ancillary Provider Seminars — Make Plans to Attend a Session
Anthem Blue Cross and Blue Shield’s ancillary office provider seminars                        Sign Up now for a 2005 Ancillary Provider Seminar
began in March and are scheduled throughout the year. Please make plans                      Register early to ensure your choice of seminar locations. When making
to attend a session tailored for your provider specialty for both new and                    plans to attend a seminar, ensure the seminar scheduled for a particular
experienced billers.                                                                         day is for your ancillary provider type and will meet your needs. (Refer to
    Anthem continues to offer these seminars — at no charge to partici-                      the seminar type column.)
pating ancillary providers — in convenient locations across the state. The                      Our seminars are designed to make doing business with Anthem easier,
following provider types* are invited to attend:                                             addressing topics like ID card information, claims filing procedures, current
      Audiologists                               Laboratories                                updates about Medical Management and product changes. In addition, the
      Certified Nurse Midwives                    Medical Equipment Suppliers                 seminars include information on Anthem Point of Care, our Web-based
      Chiropractors                              Opticians                                   application that puts Internet technology to work with secure access to
      Ground Ambulance Providers                 Optometrists                                pertinent information like claims and benefits. We have provided our semi-
      Home Infusion Therapy                      Physical, Speech and                        nar schedule in this edition of the Anthem Professional Forum.
      Providers (I.V. Therapy)                   Occupational Therapists
                                                                                             To Register by Fax OR Mail
*Medical doctors, dentists and other non-ancillary health care pro-
fessionals attend separate seminars tailored for their office needs.                          Please submit your completed reservation form to:
    Additionally, Anthem offers office seminars for home health agencies, hos-                       Fax Number:            OR       Mailing Address:
pices, dialysis centers and skilled nursing facilities using UB-92 claim forms to                   (804) 354-3029                  Anthem Blue Cross and Blue Shield
file claims. We understand the demands of busy practices and recognize that                                                          Attention: Ancillary Provider Network
                                                                                                                                    Management Seminars
some participants may have difficulty attending offsite seminars. With that in                                                       Mail Drop VA43A
mind, Anthem will offer an additional training opportunity through in-office                                                         P.O. Box 27401
seminars. Please call (804) 678-1014 to schedule an in-office session.                                                               Richmond, VA 23279
                                                                                             Seating is limited, so if you find you cannot attend please call
                                                                                             (804) 354-2338. This will allow us to assign your seat to another.


                                          Ancillary Providers Seminar Registration Form
                                                (for providers participating with Anthem)
•   Ambulance Providers                    • Dialysis Centers                                           •   Hospices                              • Optometrists
•   Audiologists                           • Home Health Agencies                                       •   Laboratories                          • Physical, Speech and
•   Certified Nurse Midwives                • Home Infusion (I.V. Therapy)                               •   Medical Equipment Suppliers             Occupational Therapists
•   Chiropractors                            Providers                                                  •   Opticians                             • Skilled Nursing Facilities

     To register for an ancillary provider seminar, fill out this form completely and fax OR mail to:    FAX:   (804) 354-3029
     OR MAIL:     ANTHEM Blue Cross and Blue Shield, Attn: Ancillary Provider Network Management Seminars, Mail Drop VA43A, P.O. Box 27401, Richmond, VA 23279

PLEASE NOTE THERE WILL BE NO CONFIRMATION OF YOUR REGISTRATION.                                As space is limited, attendance will be by reservation only. If you register
However, we will notify you if the seminar is either FULL or CANCELLED.                        and then find you cannot attend, please call (804) 354-2338 to cancel as
When registering, please remember:                                                             soon as possible or at least 24 hours in advance of the seminar.

    These seminars are for the office personnel of the particpating provider                    Because comfort levels vary and meeting rooms cannot be temperature con-
    types listed at the top of this page. Training seminars for other provider                 trolled, we suggest bringing a sweater or light jacket.
    types such as MDs, DOs, DDS, DMDs and Mental Health have a separate
    training schedule.

SEMINAR DATE AND TIME                                                                        LOCATION


ATTENDEE #1


ATTENDEE #2


PROVIDER NAME


ANTHEM PROVIDER NUMBER                                                                       PROVIDER TYPE


ADDRESS


CITY/STATE/ZIP


PHONE NUMBER (INCLUDING AREA CODE)                                                           FAX NUMBER (INCLUDING AREA CODE)


E-MAIL ADDRESS




ANTHEM           PROFESSIONAL       FORUM                                               18                                                                     APRIL        2005
                                                                           BULLETIN BOARD


2005 Ancillary Provider Seminar Schedule
    DATE            TIME                    REGION      SEMINAR TYPE                                            LOCATION/ADDRESS
    May 4           10 a.m. – 1 p.m.        Northern    Physical Therapy, Speech Therapy,                       Anthem Blue Cross and Blue Shield, Chantilly Office,
                                                        Occupational Therapy & Chiropractor Providers           3800 Concorde Parkway, Chantilly, VA 22021
                                                        Experienced Billers
    May 13          10 a.m. – 1 p.m.        Western     Physical Therapy, Speech Therapy,                       Centra Health Inc., MSO Conference Room,
                                                        Occupational Therapy & Chiropractor Providers           1204 Fenwick Drive, Lynchburg, VA 24502
                                                        Experienced Billers
    May 18          10 a.m. – 1 p.m.        Central     Physical Therapy, Speech Therapy,                       Martha Jefferson Hospital, Education Center,
                                                        Occupational Therapy & Chiropractor Providers           Kessler Conference, 320 10th Street, Charlottesville, VA 22902
                                                        Experienced Billers
    May 24          1:30 p.m. – 4:30 p.m.   Eastern     Physical Therapy, Speech Therapy,                       Mary Immaculate Hospital, Sister Sidelia Room,
                                                        Occupational Therapy & Chiropractor Providers           2 Bernardine Drive, Newport News, VA 23602
                                                        Experienced Billers
    June 8          10 a.m. – 1 p.m.        Western     Medical Equipment Providers                             Anthem Blue Cross and Blue Shield, Roanoke Office,
                                                        All Lines of Business                                   602 South Jefferson Avenue, 1st Floor Jefferson Room,
                                                                                                                Roanoke, VA 24011
    June 15         1:30 p.m. – 4:30 p.m.   Central     Medical Equipment Providers                             Henrico Doctors’ Hospital, Williamsburg Room B,
                                                        All Lines of Business                                   1602 Skipwith Road, Richmond, VA 23229
    June 22         9 a.m. – 12 p.m.        Eastern     Medical Equipment Providers                             Sentara Virginia Beach General Hospital,
                                                        All Lines of Business                                   Health Education Center, 1060 1st Colonial Road,
                                                                                                                Virginia Beach, VA 23454
    June 29         10 a.m. – 1 p.m.        Northern    Medical Equipment Providers                             Prince William Hospital, 4th Floor Conference Room A,
                                                        All Lines of Business                                   8700 Sudley Road, Manassas, VA 20110
    July 19         9 a.m. – 12 p.m.        Central     Home Health Agencies, Skilled Nursing Facilities,       Anthem Blue Cross and Blue Shield, Davis Center,
                                                        Hospices, Dialysis Centers,                             Virginia Room, 2015 Staples Mill Road, Richmond, VA 23229
                                                        (UB-92 Billers)
    July 20         10 a.m. – 1 p.m.        Eastern     Home Health Agencies, Skilled Nursing Facilities,       DePaul Hospital, Price Auditorium A, 150 Kingsley Lane,
                                                        Hospices, Dialysis Centers,                             Norfolk, VA 23505
                                                        (UB-92 Billers)
    July 26         10 a.m. – 1 p.m.        Northern    Home Health Agencies, Skilled Nursing Facilities,       Anthem Blue Cross and Blue Shield, Chantilly Office,
                                                        Hospices, Dialysis Centers,                             3800 Concorde Parkway, Chantilly, VA 22021
                                                        (UB-92 Billers)
    July 28         1 p.m. – 4 p.m.         Western     Home Health Agencies, Skilled Nursing Facilities,       Fralin and Waldron Office Park, Building E, Suite 200,
                                                        Hospices, Dialysis Centers,                             2917 Penn Forest Boulevard, Roanoke, VA 24018
                                                        (UB-92 Billers)
    September 12    10 a.m. – 1 p.m.        Western     Introductory Billing Seminar                            Anthem Blue Cross and Blue Shield, Roanoke Office,
                                                        For all new Ancillary CMS-1500 Billers                  602 South Jefferson Avenue, 1st Floor Jefferson Room,
                                                                                                                Roanoke, VA 24011
    September 14    10 a.m. – 1 p.m.        Northern    Introductory Billing Seminar                            Prince William Hospital, 4th Floor Conference Room A,
                                                        For all new Ancillary CMS-1500 Billers                  8700 Sudley Road, Manassas, VA 20110
    September 20    9 a.m. – 12 p.m.        Central     Introductory Billing Seminar                            Henrico Doctors’ Hospital, Williamsburg Room A,
                                                        For all new Ancillary CMS-1500 Billers                  1602 Skipwith Road, Richmond, VA 23229
    September 28    9 a.m. – 12 p.m.        Eastern     Introductory Billing Seminar                            Sentara Virginia Beach General Hospital,
                                                        For all new Ancillary CMS-1500 Billers                  Health Education Center, 1060 First Colonial Road,
                                                                                                                Virginia Beach, VA 23454
    October 5       10 a.m. – 1 p.m.        Northern    Physical Therapy, Speech Therapy,                       Mary Washington Hospital, Training Room A & B,
                                                        Occupational Therapy & Chiropractor Providers           1001 Sam Perry Boulevard, Fredericksburg, VA 22401
                                                        Experienced Billers
    October 11      10 a.m. – 1 p.m.        Western     Physical Therapy, Speech Therapy,                       Virginia Baptist Hospital, Centra Health Inc.,
                                                        Occupational Therapy & Chiropractor Providers           Craddock Auditorium, 3300 Rivermont Avenue,
                                                        Experienced Billers                                     Lynchburg, VA 24503
    October 19      1:30 p.m. – 4:30 p.m.   Eastern     Physical Therapy, Speech Therapy,                       Mary Immaculate Hospital, Sister Sidelia Room,
                                                        Occupational Therapy & Chiropractor Providers           2 Bernardine Drive, Newport News, VA 23602
                                                        Experienced Billers
    October 26      9 a.m. – 12 p.m.        Central     Physical Therapy, Speech Therapy,                       CJW Johnston-Willis Hospital, 1st Floor, Main Auditorium,
                                                        Occupational Therapy & Chiropractor Providers           1401 Johnston Willis Drive, Richmond, VA 23235
                                                        Experienced Billers

Anthem offers ancillary provider office seminars for the provider types below. Please refer to the
“Seminar Type” column in the above schedule to ensure you are registering for the appropriate
office seminar based on your ancillary provider type.
•   Ambulance Providers                     • Dialysis Centers                                    •   Hospices                                   • Optometrists
•   Audiologists                            • Home Health Agencies                                •   Laboratories                               • Physical, Speech and
•   Certified Nurse Midwives                 • Home Infusion (I.V. Therapy)                        •   Medical Equipment Suppliers                  Occupational Therapists
•   Chiropractors                             Providers                                           •   Opticians                                  • Skilled Nursing Facilities



ANTHEM           PROFESSIONAL          FORUM                                            19                                                                       APRIL      2005
                                                                                                                                             P r s r t S t d M a il
                                                                                                                                              U . S . Po s t a g e

                                                                                                                                              PAID
Anthem Professional Forum                                                                                                                     Manchester, NH
                                                                                                                                               Permit 197
2221 Edward Holland Drive
Richmond,VA 23230
Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans
of Virginia,Inc.Anthem Blue Cross and Blue Shield and its affiliated HMOs,
HealthKeepers,Inc.,Peninsula Health Care,Inc.and Priority Health Care,Inc.,
are independent licensees of the Blue Cross and Blue Shield Association.
® Registered marks Blue Cross and Blue Shield Association.




                                                                              H I PA A U P DAT E


HIPAA National Provider Identifier Coming In 2005
Anthem Blue Cross and Blue Shield is committed to delivering                                Ultimately, the NPI will replace all your existing identification
distinctive service.Part of that commitment includes compli-                                numbers including Medicare, Medicaid and all payers’identifi-
ance with and support of the Health Insurance Portability and                               cation numbers including your Anthem-assigned provider
Accountability Act of 1996 (HIPAA).The HIPAA National                                       identification number.
Provider Identifier Final Rule (NPI) issued Jan.23,2004,offers                               Look for more information about NPI use with Anthem
each physician,health care professional and institution one                                 in subsequent articles appearing in the Anthem Professional
unique identifier for all transactions related to the rendition of                           Forum.
and payment for health care services.Here is important infor-
                                                                                            Covered entities — (health care providers,clearinghouses
mation that you need to know about NPI:
                                                                                            and health plans) — will be required to use NPIs no later
     The Centers for Medicare and Medicaid Services (CMS) will                              than May 23,2007;(small health plans are allowed an
     oversee the NPI process.                                                               additional 12 months to comply).
     To obtain your NPI,physicians,health care professionals and                          To learn more about NPI from CMS,please visit online
     institutions will be required to submit an application to                            www.cms.hhs.gov/hipaa/hipaa2/ or call the CMS HIPAA
     CMS.You may obtain these applications from CMS’Web site,                             Hotline at (866) 282-0659.To help meet your compliance efforts,
     listed below,in the coming months.Going forward,CMS may                              we’ve expanded our newsletters,www.hipaa.anthem.com and
     offer additional application options.                                                www.edi.anthem.com to include NPI information specific to
     NPI applications will be accepted by CMS beginning                                   Anthem Blue Cross and Blue Shield.We encourage you to routine-
     May 23,2005.                                                                         ly review these sites to obtain the most up-to-date information.


                                                                                     20                                                          APRIL      2005

				
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