PCMI Newsletter March 2008 by c0aAXw

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									PCMI Newsletter
March 2008



Blue Cross of California becomes Anthem Blue Cross on April 1

Blue Cross of California begins doing business as Anthem Blue Cross on April
1, 2008. We're excited about our new name, since it more effectively
symbolizes what our plans represent: the security of Anthem's heritage with
the strength and stability of Blue Cross.

As Anthem Blue Cross, we'll be able to leverage an advantage that our
competitors can't claim - our size. The Anthem name showcases our status as
the nation's largest health benefits company, and when combined with our
local market focus, we're better situated to offer our consumers a more
complete benefits solution.

This means Blue Cross of California products and services will be offered
under the Anthem Blue Cross brand. Blue Cross of California's affiliate BC
Life & Health Insurance Company is also adopting the Anthem brand and has
changed its name to Anthem Blue Cross Life and Health Insurance Company.

The brand change to Anthem is effective for our complete product portfolio
including medical, dental, vision, life, employee assistance programs and
behavioral health services.

The Anthem brand, used by 11 other health plans across the country, is a
well-recognized health benefits brand known for quality, affordable health
care coverage, and it has a strong reputation in the market as a trusted
choice for consumers. The new brand name in California will continue to
embody the consistency, strength, security and stability of the Blue Cross
name.

Rest assured, while our name and logo will be different, your partnership
with us will remain the same. Soon we will have new logos, taglines and
branding guidelines to share with you.

This change also includes re-issuing ID cards to all California
participants. The ID card re-issue project begins August 1, 2008 for all
PCMI participants and is scheduled to be completed by January 1, 2009. ID
cards will be reprinted as part of our routine printing process as
eligibility and benefit changes occur.

Additionally, the Blue Cross of California website URL is changing to
http://www.anthem.com/ca.

It is important to note that during this branding transition any previous
communication pieces, website address, and ID cards will be honored by
providers.
FDA approves Zyrtec and Zyrtec-D for Over-The-Counter (OTC) use

The U.S. Food and Drug Administration recently approved tablet, chewable
tablet and syrup formulations of Zyrtec (cetirizine HCl) for OTC
nonprescription use effective January 23, 2008.

The nonprescription drug is approved for the temporary relief of symptoms
due to hay fever or other respiratory allergies (sneezing; runny nose;
itchy, watery eyes; itchy throat or nose) in adults and children 2 years of
age and older. The nonprescription Zyrtec products are approved for the
relief of itching due to hives in people 6 years of age and older, including
adults.

The tablets and chewable tablets are approved for adults and children 6
years of age and older:

.   for the treatment of the symptoms of hay fever and other respiratory
    allergies, and

.   to relieve itching due to hives.

The syrup is approved for:

.   adults and children 2 years of age and older for the treatment of the
    symptoms of hay fever and other respiratory allergies, and

.   adults and children 6 years of age and older to relieve itching due
    to hives

The company will market 2 distinct Zyrtec products for each dosage form. One
will provide directions for treating the symptoms of hay fever and other
respiratory allergies. The other will contain directions for use to relieve
the itching due to hives.

Zyrtec may cause drowsiness in some people at recommended doses. Other
common side effects include fatigue and dry mouth.

On November 9, 2007, the FDA announced that it had approved Zyrtec-D, a
product which contains cetirizine HCl and pseudoephedrine HCl, for OTC
nonprescription use. Sales of Zyrtec-D are subject to restrictions in the
Combat Methamphetamine Epidemic Act. This law places restrictions on the
sale of products containing pseudoephedrine, such as limiting the amount
that an individual can purchase, and imposing record keeping requirements on
the retail establishments that sell the product and that it is located with
the pharmacist.

Nonprescription Zyrtec-D was approved for the relief of symptoms due to hay
fever or other upper respiratory allergies such as runny nose, sneezing,
itchy, watery eyes, itching of the nose or throat and nasal congestion.
Zyrtec-D is also approved for reducing swelling of nasal passages, for
relief of sinus congestion and pressure and for restoring freer breathing
through the nose due to hay fever and other upper respiratory allergies.
Zyrtec-D is not approved for the relief of itching due to hives.
Zyrtec is marketed and distributed by McNeil Consumer Healthcare, based in
Fort Washington, Pennsylvania.

Please contact your broker for information on how this may impact your
prescription drug card benefits.

New ID card printer improves turnaround time to customers

PCMI recently installed a new identification card printer - the Datacard
7000, to enhance printing and generating ID cards for our customers. The
Datacard 7000 features an easy-to-use software package that simplifies the
entire card issuance process. The new system prints about 20 cards per
minute on both sides, at the same time, cutting printing time by more than
half. ID cards that previously took up to 3 days to print now only take 1
day. The ID card printer generates cards much faster, which improves the
turnaround time in sending ID cards to our customers.

PCMI is also in the process of upgrading the ID card software to print and
process ID cards prior to a group or individual's effective date. This
enhancement is scheduled to go into production in June 2008.

Although the new ID card printer has only been in production for a few
weeks, it has already proven to be highly reliable. It also provides
features that will allow PCMI to upgrade the system by adding new modules to
support future growth.

Soft denial of claims generates faster response from providers

PCMI has implemented "soft denial" of claims management. Soft denial of
claims generates a much faster response from providers when required claims
information is missing, which produces a faster payment turnaround time to
our customers. Previously, when a provider submitted a claim that was
missing required information such as attending physician or diagnosis code,
it would be "pended" and a letter would be sent to the provider requesting
the missing information. Response from providers to these letters was very
slow, sometimes taking months to receive.

Now, when a claim is submitted missing required information, it is "soft
denied," or temporarily denied, which means that the claim is closed until
PCMI receives the required information from the provider. Once the required
information is received, the claim is reopened as a new claim, and processed
for payment.

Soft denial of claims has improved response time from providers as well as
claims payment turnaround time to our customers. Why do providers respond to
"soft denial" of a claim much faster than they do "pended claim" letters?
Pended claim letters go to the provider's customer service representative,
however, denial of benefits directly impact their bottom line so the
provider has an incentive to respond quickly.
Pinnacle Spotlight

Tina Thoman for newsletter

Tina Thoman - Supervisor of Benefit Distribution and Installation

Tina Thoman has been promoted to Supervisor of Benefit Distribution and
Installation. She has over 20 years of experience in the organization and
health benefits. Her responsibilities include overseeing the installation
of new groups, plan changes and distribution of benefit materials and ID
cards. Please send all requests for materials to Tina's attention. You can
contact Tina at 949-885-2232 or email: tthoman@pinnacletpa.com.

If you wish to have someone added to the distribution list, please e-mail
pcminewsletter@pinnacletpa.com.

								
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